title: [Congenital diaphragmatic hernia. Therapeutic re-evaluation].
abstract: Twenty-eight patients with "High-Risk" diaphragmatic hernia were treated without postoperative ipsilateral chest drains. Overall survival was 71%. This study suggests that, in cases of complete absence of the diaphragm, the use of a mesh pervious to air is as noxious postoperatively as an underwater chest drain. This idea is supported by experiments in cats with a left pneumonectomy, in which part of the diaphragm was replaced either by a macroporous mesh or by a microporous prosthesis impervious to air at normal pressures. Moreover, barotrauma may occur preoperatively and when assisted ventilation is required, inspiratory pressure must be strictly limited.
authors.affiliation: Service de Chirurgie Pédiatrique et d'Anesthésie, Centre Hospitalier de l'Université Laval, Sainte-Foy, Québec, Canada.
authors.forename: R
authors.initials: R
authors.lastname: Cloutier
authors.forename: L
authors.initials: L
authors.lastname: Fournier
authors.forename: D
authors.initials: D
authors.lastname: Major
authors.forename: L
authors.initials: L
authors.lastname: Béland
authors.forename: J
authors.initials: J
authors.lastname: Péloquin
authors.forename: P
authors.initials: P
authors.lastname: Poncelet
mesh_terms: D000818:Animals; D002415:Cats; D003964:Diaphragm / Q000601:surgery*; D004322:Drainage / Q000009:adverse effects; D006548:Hernia, Diaphragmatic / Q000601:surgery; D065630:Hernias, Diaphragmatic, Congenital; D006801:Humans; D007231:Infant, Newborn; D010795:Phthalic Acids; D011013:Pneumonectomy; D011092:Polyethylene Glycols; D011093:Polyethylene Terephthalates; D011138:Polytetrafluoroethylene; D011183:Postoperative Complications; D011312:Pressure; D013526:Surgical Mesh; D013909:Thorax / Q000502:physiology
chemical_list: D010795:Phthalic Acids; D011093:Polyethylene Terephthalates; C025539:Lavsan; D011092:Polyethylene Glycols; D011138:Polytetrafluoroethylene
vernacular_title: La hernie diaphragmatique congénitale. Réévaluation thérapeutique.