Deprecated: Implicit conversion from float 213.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 213.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 213.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 213.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 213.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 213.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 247.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 247.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 247.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 247.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 247.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 247.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Warning: imagejpeg(C:\Inetpub\vhosts\kidney.de\httpdocs\phplern\26051693
.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 Dtsch+Arztebl+Int
2015 ; 112
(20
): 357-64
Nephropedia Template TP
gab.com Text
Twit Text FOAVip
Twit Text #
English Wikipedia
The Surgical Correction of Congenital Deformities: The Treatment of Diaphragmatic
Hernia, Esophageal Atresia and Small Bowel Atresia
#MMPMID26051693
Wessel LM
; Fuchs J
; Rolle U
Dtsch Arztebl Int
2015[May]; 112
(20
): 357-64
PMID26051693
show ga
BACKGROUND: More than half of all congenital deformities can be detected in
utero. The initial surgical correction is of paramount importance for the
achievement of good long-term results with low surgical morbidity and mortality.
METHODS: Selective literature review and expert opinion. RESULTS: Congenital
deformities are rare, and no controlled trials have been performed to determine
their optimal treatment. In this article, we present the prenatal assessment,
treatment, and long-term results of selected types of congenital deformity.
Congenital diaphragmatic hernia (CDH) affects one in 3500 live-born infants,
while esophageal atresia affects one in 3000 and small-bowel atresia one in 5000
to 10,000. If a congenital deformity is detected and its prognosis can be
reliably inferred from a prenatal assessment, the child should be delivered at a
specialized center (level 1 perinatal center). The associated survival rates are
60-80% after treatment for CDH and well over 90% after treatment for esophageal
or small-bowel atresia. Despite improvements in surgical correction over the
years, complications and comorbidities still affect 20-40% of the treated
children. These are not limited to surgical complications in the narrow sense,
such as recurrence, postoperative adhesions and obstruction, stenoses,
strictures, and recurrent fistulae, but also include pulmonary problems (chronic
lung disease, obstructive and restrictive pulmonary dysfunction),
gastrointestinal problems (dysphagia, gastro-esophageal reflux, impaired
intestinal motility), and failure to thrive. Moreover, the affected children can
develop emotional and behavioral disturbances. Minimally invasive surgery in
experienced hands yields results as good as those of conventional surgery, as
long as proper selection criteria are observed. CONCLUSION: Congenital
deformities should be treated in recognized centers with highly experienced
interdisciplinary teams. As no randomized trials of surgery for congenital
deformities are available, longitudinal studies and registries will be very
important in the future.