- 선천성 횡격막 탈장의 지연수술 결과
- ㆍ 저자명
- 이석구,김현학,김경헌,장윤실,박원순,Lee. Suk-Koo,Kim. Hyun-Hahk,Kim. Kyung-Hun,Chang. Yun-Sil,Park. Won-Soon
- ㆍ 간행물명
- 소아외과
- ㆍ 권/호정보
- 2001년|7권 1호|pp.21-25 (5 pages)
- ㆍ 발행정보
- 대한소아외과학회
- ㆍ 파일정보
- 정기간행물| PDF텍스트
- ㆍ 주제분야
- 기타
Congenital diaphragmatic hernia (CDH) in the past was considered a surgical emergency requiring immediate operation. Several groups now advocate preoperative stabilization and delayed surgery. The treatment strategy for CDH in this institution is delayed surgery after preoperative stabilization. The aim of this study was to evaluate the results of delayed surgery. A retrospective review of 16 neonates with CDH was performed. Surfactant. conventional mechanical ventilation. high frequency oscillation. and nitric oxide were utilized for preoperative stabilization as necessary. The difference in outcome between two groups differentiated by the duration of the preoperative stabilization periods with mechanical ventilation (${leq}$ 8 hours and > 8 hours) was determined. Chi-square test was used to analyze the data. There were 7 right-sided hernias and 9 left. The average duration of stabilization was 32.4 hours. Hepatic herniation through the defect was found in 6 cases and all died. The most common postoperative complication was pneumothorax. The mortality rate of the right side hernia was higher than the left (85.7% vs. 33.3%. p=0.036). Mortality rate of the group (N=8) whose preoperative stabilization period was 8 hours or less was better than that (N=6) whose preoperative stabilization period was more than 8 hours (25.0% vs. 83.3%. p=0.031). The overall mortality rate was 56.3%. The better prognosis was noticed in left side hernia. no liver herniation, or shorter preoperative stabilization period.