AN ACTUAL METHODS OF RIGHT-SIDED CONGENITAL DIAPHRAGMATIC HERNIAS SURGICAL TREATMENT

I. I. Lovskaya; M. G. Chepurnoy; G. I. Chepurnoy; V. B. Katsupeev; B. G. Rozin

doi:10.21886/2219-8075-2014-3-117-120

AN ACTUAL METHODS OF RIGHT-SIDED CONGENITAL DIAPHRAGMATIC HERNIAS SURGICAL TREATMENT

I. I. Lovskaya, M. G. Chepurnoy, G. I. Chepurnoy, V. B. Katsupeev, B. G. Rozin

https://doi.org/10.21886/2219-8075-2014-3-117-120

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Abstract

Purpose: to improve the surgical treatment outcomes in children with right-sided congenital diaphragmatic hernias (RCDH).
Materials and methods. An anatomical experimental study included filing vena cava inferior and hepatic veins with barium suspense was carried out in 4 children’s corps: with RCDH (2) and the control – without RCDH (2). An X-ray vasographic comparison was performed. Carrying out a clinical part of investigation, two groups of patients were compared: operated till 2008 (22 children) when forced replacement of liver under the diaphragm with its followed closure above the liver, and operated after 2008 (11 children) with partial closure of a diaphragmatic defect up to the liver and followed diaphragmaplasty with synthetic lattice. Clinical and X-ray examinations were performed then.
Results. An anatomic research revealed that hepatic veins in RCDH corps were situated upper than in control corps in ½ or 1 thoracic vertebra. In the first group children lethal outcomes was in 9 patients (40.9%), in second group there were no any lethal outcomes.
Summary: 1. RCDH must be considered as an intrathoracic liver ectopic position. 2. There is rational to use transthoracic approach in children with such a pathology.