Congenital Diaphragmatic Hernia: A Review of Its Management

Congenital Diaphragmatic Hernia (CDH) is considered a defect in diaphragm development which occurs congenitally, its incidence is about 1 in 2500 newborns. Major components of CDH are increased pul­monary pressure with fetal circulation persistence, with significant reduction in lung compliance and its tidal volume. Preoperative stabilization and optimization should preceed the surgical repair which is done usually via laparotomy which is considered to be the standard approach. Minimally invasive procedures for CDH repair provides the patient with the benefit of less pain and avoidance of the consequences of thoracotomy or laparotomy compared with the open repair strategy, inspite of prescence of disadvantages mainly from insufflation and CO2 absorption, but this can be controlled with lower CO2 pressure, better insufflation instruments and continuous monitoring of blood gases.