The first experience in Ukraine of total replacement of a diaphragm defect (with its aplasia) by a muscle autograft in a newborn child
DOI:
https://doi.org/10.15574/PS.2022.75.20Keywords:
congenital diaphragmatic hernia, diaphragmatic aplasia, surgical correction, flap of the muscles of the anterior abdominal wall, newborn babyAbstract
Congenital diaphragmatic hernias, in newborns, with large defect of the diaphragm, are an extreme risk group and characterized by high mortality.
We present our own experience of successful surgical treatment of a newborn with aplasia of the left half of the diaphragm. The child was born in the State Institution «Institute of Pediatrics, Obstetrics and Gynecology named after academician O.M. Lukyanova National Academy of Medical Sciences of Ukraine» with a prenatal diagnosis. After preoperative stabilization, for the first time in Ukraine, the left half of the diaphragm was completely replaced with a split muscle flap from the anterior abdominal wall. The child survived after the operation, his physical development corresponds to age. During the 3-year follow-up, there are no signs of recurrence.
The research was carried out in accordance with the principles of the Helsinki Declaration. The informed consent of the patient was obtained for conducting the studies.
No conflict of interests was declared by the authors.
References
Barnhart DC, Jacques E, Scaife ER. (2012). Split abdominal wall muscle flap repair vs patch repair of large congenital diaphragmatic hernias Journal of Pediatric Surgery. 47: 81-86. https://doi.org/10.1016/j.jpedsurg.2011.10.023; PMid:22244397
Burgos CM, Frenckner B. (2017). Addressing the hidden mortality in CDH: A population-based study. Journal of Pediatric Surgery. 52: 522-525. https://doi.org/10.1016/j.jpedsurg.2016.09.061; PMid:27745705
Coughlin MA, Werner NL, Gajarski R et al. (2016). Prenatally diagnosed severe CDH: mortality and morbidity remain high. J Pediatr Surg. 51 (7): 1091-1095. https://doi.org/10.1016/j.jpedsurg.2015.10.082; PMid:26655216
Coughlin MA, Werner NL, Gajarski R. (2016). Prenatally diagnosed severe CDH: mortality and morbidity remain high Journal of Pediatric Surgery. 51: 1091-1095. https://doi.org/10.1016/j.jpedsurg.2015.10.082; PMid:26655216
Coughlin MA, Werner NL, Gajarski R. (2016). Prenatally diagnosed severe CDH: mortality and morbidity remain high. Journal of Pediatric Surgery. 51: 1091-1095. https://doi.org/10.1016/j.jpedsurg.2015.10.082; PMid:26655216
Garne E, Haeusler M, Barisic I et al. (2002). Congenital diaphragmatic hernia: evaluation of prenatal diagnosis in 20 European regions. Ultrasound Obstet Gynecol. 19: 329-333. https://doi.org/10.1046/j.1469-0705.2002.00635.x; PMid:11952959
Harrison MR, Bjordal RI, Langmark F et al. (1978). Congenital diaphragmatic hernia: the hidden mortality. J Pediatr Surg. 13: 227-230. https://doi.org/10.1016/S0022-3468(78)80391-1
Joshi SB, Sen S, Chacko J et al. (2005). Abdominal muscle flap repair for large defects of the diaphragm. Pediatr Surg Int. 21: 677-680. https://doi.org/10.1007/s00383-005-1438-1; PMid:16010546
McGivern MR, Best KE, Rankin J et al. (2015). Epidemiology of congenital diaphragmatic hernia in Europe: a register-based study. Arch Dis Child Fetal Neonatal Ed. 100: 137-144. https://doi.org/10.1136/archdischild-2014-306174; PMid:25411443
Meeker Jr IA. (1962). Surgical management of diaphragmatic defects in the newborn infant. Am J Surg. 104: 196-203. https://doi.org/10.1016/0002-9610(62)90319-7
Nasr A, Struijs MC, Ein SH et al. (2010). Outcomes after muscle flap vs prosthetic patch repair for large congenital diaphragmatic hernias. J Pediatr Surg. 45: 151-154. https://doi.org/10.1016/j.jpedsurg.2009.10.024; PMid:20105596
Nasr A, Struijs MC, Ein SH, Langer JC, Chiu PPL. (2010). Outcomes after muscle flap vs prosthetic patch repair for large congenital diaphragmatic hernias. J Pediatr Surg. 45 (1): 151-154. https://doi.org/10.1016/j.jpedsurg.2009.10.024; PMid:20105596
Scaife ER, Johnson DG, Meyers RL et al. (2003). The split abdominal wall muscle flap-a simple, mesh-free approach to repair large diaphragmatic hernia. J Pediatr Surg. 38: 1748-1751. https://doi.org/10.1016/j.jpedsurg.2003.08.045; PMid:14666458
Simpson JS, Gossage JD. (1971). Use of abdominal wall muscle flap in repair of large congenital diaphragmatic hernia. J Pediatr Surg. 6: 42-44. https://doi.org/10.1016/0022-3468(71)90666-X
Slepov OK, Ponomarenko OP, Slepova LF. (2013). Clinical-instrumental and laboratory criteria of readiness for radical correction of congenital diaphragmatic hernia in newborns. International Journal of Pediatrics, Obstetrics and Gynecology. IV (1): 72-73.
Slyepov ОK, Ponomarenko OP, Shypot OG, Тalkо MO. (2016). Recurrent congenital diaphragmatic hernias: causes and possible risk factors, methods of re-surgical correction (literature review and own observations). Perinatologiya i pediatriya. 65 (1): 112-117. doi 10.15574/PP.2016.65.112
Zamora IJ, Olutoye OO, Cass DL et al. (2014). Prenatal MRI fetal lung volumes and percent liver herniation predict pulmonary morbidity in congenital diaphragmatic hernia (CDH). J Pediatr Surg. 49: 688-693. https://doi.org/10.1016/j.jpedsurg.2014.02.048; PMid:24851749
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