Laparoscopic surgery saved life of a pediatric patient with congenital diaphragmatic hernia

05/07/2021 15:45

Recently, Viet Duc University Hospital received a pediatric patient B.V.D. with congenital diaphragmatic hernia. Throughout medical history, the doctors have been informed that in the pre-birth ultrasound at 37^th week of pregnancy, that due to findings of intestines in the thoracic cavity so the mother was transferred to the National Hospital of Obstetrics and Gynecology for a cesarean. Right after birth, the child was immediately  taken to Viet Duc University Hospital for a surgery.

 

Dr. NGUYEN Viet Hoa PhD., MD., Head of Pediatric and Neonatal Surgery Department, Viet Duc University Hospital, who directly performed the operation, shared that: Early after birth, children with diaphragmatic hernias often manifest the respiratory failure, therefore they need to be monitoring with intensive care at a neonatal service for any further supports immediately. This is the deadliest stage without timely proper intervention in emergency. For this reason, periodical check during pregnancy for early detection by ultrasound is playing an important role for an after-birth treatment plan. Diaphragmatic hernia repair requires to be performed in a specialized medical center for neonatal surgery together with qualified anesthesiology and intensive care. For this case, patient D. weighted 2500 grams, in the first day of his life, was operated with Video Assisted Thoracotomy technique with 3-mm devices to bring intestines and spleen back to the abdominal cavity and to repair the diaphragmatic defect. Postoperatively, patient was under mechanical ventilation and intensive care. By now, on the third postoperative day, he was stable, able to self-breath and breast-feed.

 

 

Dr. NGUYEN Viet Hoa PhD., MD., added that congenital diaphragmatic hernia is a defect leading the abdominal organs as small intestines, colon, stomach, spleen, liver moving up the thoracic cavity during pregnancy causing pulmonary hypoplasia. The prevalence is about 1/2500 – 1/5000 children. The most common site of diaphragmatic hernia is in the left, accounting 90% and by posterolateral  diaphragm defect (Bochdalek hernia type). The most frequent cause of death is pulmonary hypoplasia and pulmonary arterial hypertension associating with other congenital defects. In the past, the mortality rate was more than 60%.

 

Nowadays, thanks to the development of pre-birth early detection, neonatal intensive care and surgical intervention, the mortality rate has been remarkably reduced. The survival rate of congenital diaphragmatic hernia is 80 – 90%.

 

At Pediatric and Neonatal Surgery Department, Viet Duc University Hospital, physicians provide medical service and consultation to early detect congenital defects of genital organs such as phimosis, buried penis, hypospadias, curved penis, inguinal hernia, cryptorchidism, varicocele…, of urinary system such as hydronephrosis with renal and ureteral dilatation, vesicoureteral reflux…, of digestive disorders, congenital tumors and other defects of extremities and chest such as polydactyly, extremity malformation, pectus excavatum…

 

By now, facing to a complicated and dangerous Covid-19 pandemic, Viet Duc University Hospital has implemented many interventions to ensure the safety for patients. In the Pediatric and Neonatal Surgery Department, comprehensive care service has been deployed in order to make the family completely assured when bringing their child to hospital for treatment. The hospital’s target is to secure the safety for all patients, their relatives and medical staff in the hospital while doing our healthcare tasks. Grateful from hospital and best wishes to patients and families for kind understanding and cooperation for this matter.