title: Repair of congenital diaphragmatic hernias through umbilical skin incisions.
abstract: The use of thoracoscopy and laparoscopy in the treatment of congenital diaphragmatic hernias (CDHs) has been recently reported; however, the use of these procedures still remains controversial due to CO2 insufflation and limited working space. In addition, because of difficult techniques, it has not been widely accepted. Among CDH patients, mild cases whose lung is not hypoplastic, and not associated with persistent pulmonary hypertension of the neonate (PPHN) often develop small defects in the diaphragm that can be repaired using "direct closure." Because direct closure does not require as wide an operative field as that needed for patch closure, we repaired CDH through umbilical skin windows in two neonates with mild CDH to minimize the wounds. With the creation of additional radical small incisions, the surgeries were successfully performed without any intra- or postoperative complications, and the wounds were cosmetically pleasing. The repair of CDHs through umbilical skin windows is a feasible and useful approach in neonates with mild CDH.
authors: Division of Pediatric Surgery, Department of Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan. uehara@pedsurg.med.osaka-u.ac.jp
authors: Shuichiro
authors: S
authors: Uehara
authors: Noriaki
authors: N
authors: Usui
authors: Masafumi
authors: M
authors: Kamiyama
authors: Kazunori
authors: K
authors: Masahata
authors: Keigo
authors: K
authors: Nara
authors: Takehisa
authors: T
authors: Ueno
authors: Hideki
authors: H
authors: Soh
authors: Takaharu
authors: T
authors: Oue
authors: Masahiro
authors: M
authors: Fukuzawa
mesh_terms: D005260:Female; D006548:Hernia, Diaphragmatic / Q000601:surgery; D065630:Hernias, Diaphragmatic, Congenital; D006801:Humans; D007231:Infant, Newborn; D014472:Umbilicus / Q000601:surgery*