The management of Bochdalek congenital diaphragmatic hernia: a single center experience and review of the literature

Abstract

Objectives: Congenital diaphragmatic hernia (CDH) is a rare congenital anomaly of the diaphragm withpulmonary hypoplasia and persistent pulmonary hypertension and has serious consequences. Despite recentdiagnosis and treatment strategies, CDH is still a challenging condition. We aim to present our clinicalexperiences of CDH, and review of the literature.Methods: Data of CDH patients who were operated in our clinic between January 2010 and September 2018were obtained from the patient's chart. The clinical course and results of the patients with Bochdalek type CDHwere reviewed.Results: We performed diaphragmatic closure in 16 patients with Bochdalek CDH during study period.Fourteen (82%) cases were diagnosed antenatally. In 5 (29%) patients, preoperative pulmonary hypertensiondeveloped and nitric oxide was administered. Twelve of the sixteen patients (75%) underwent primary repairand 4 of them underwent prosthetic patch. Three patients were repaired thoracoscopically. Five (31%) patientsdied due to severe persistent pulmonary hypertension on postoperative period. There was no recurrence in ourpatients who were followed-up for a mean of 27 months.Conclusion: In the management of Bochdalek CDH, the clinical success has been increasing in parallel withthe important developments with the application of new treatment modalities in the neonatal intensive careunits and new surgical techniques in recent years.