Aim To evaluate the therapeutic strategies used in neonates with congenital diaphragmatic hernia (CDH) during the last fifteen years in our department.
Method A retrospective study of 27 neonates with CDH treated at the Neonatal Intensive Care Unit at Ulleval University Hospital between 1992 and 2006. The patients were divided into two groups; from 1992 to 1996 (9 patients), and from 1997 (18 patients). Since 1992 we have used a delayed operative repair, and from 1997 we started using surfactant replacement and iNO.
Results The overall survival was 70.4%. The first group had an exceptionally good outcome, 100% vs 55.5% in the last group.
Conclusion New therapeutic modalities during the last ten years have not resulted in a better outcome. Pulmonary hypoplasia and hypertension are still the most challenging factors in the treatment of these patients. Management of CDH requires experienced neonatologists and paediatric surgeons. Delayed surgery in CDH allows preoperative stabilization of newborns and makes it possible to avoid surgery in the newborns that are most likely to die.