title: Possibilities and limits in the treatment of congenital diaphragmatic hernia.
abstract: OBJECTIVE
  to establish a therapeutic strategy that will improve the prognosis and increase the survival rate in congenital diaphragmatic hernia.
  
  
  METHODS
  14 congenital diaphragmatic hernias (incidence 1/1597 live births, 12 boys and 2 girls with a sex ratio of 6/1, 10 term infants and 4 preterm first degree, 11 natural births and 3 by caesarean section) admitted to the Clinic of Pediatric Surgery Craiova, in a 5-year period (2007-2012), were analyzed from the therapeutic point of view. The "tension free" primary suture was the main surgical procedure to repair the diaphragmatic defect in all cases, preceded by a period of preoperative resuscitation and stabilization (2.8 days on average).
  
  
  RESULTS
  We registered a survival rate of 64.29% and a postoperative mortality rate of 35.71%.
  
  
  CONCLUSIONS
  delayed surgery preceded by a period of the preoperative respiratory resuscitation and stabilization (24-72 hours on average) significantly reduced postoperative mortality and increased the survival rate.
authors.affiliation: 1st Surgical Clinic, Craiova University of Medicine and Pharmacy, Craiova, Romania.
authors.forename: R
authors.initials: R
authors.lastname: Georgescu
authors.affiliation: Intensive Care Unit, Craiova University of Medicine and Pharmacy, Craiova, Romania.
authors.forename: L
authors.initials: L
authors.lastname: Chiuţu
authors.affiliation: 1st Surgical Clinic, Craiova University of Medicine and Pharmacy, Craiova, Romania.
authors.forename: R
authors.initials: R
authors.lastname: Nemeş
authors.affiliation: 1st Surgical Clinic, Craiova University of Medicine and Pharmacy, Craiova, Romania.
authors.forename: I
authors.initials: I
authors.lastname: Georgescu
authors.affiliation: Pediatric Surgical Clinic, Craiova University of Medicine and Pharmacy, Craiova, Romania.
authors.forename: A
authors.initials: A
authors.lastname: Stoica
authors.affiliation: 1st Surgical Clinic, Craiova University of Medicine and Pharmacy, Craiova, Romania.
authors.forename: E
authors.initials: E
authors.lastname: Georgescu
mesh_terms: D005260:Female; D065630:Hernias, Diaphragmatic, Congenital / Q000453:epidemiology* / Q000601:surgery*; D006801:Humans; D007223:Infant; D008297:Male; D011183:Postoperative Complications / Q000401:mortality*; D011300:Preoperative Care / Q000379:methods*; D011379:Prognosis; D012151:Resuscitation / Q000379:methods; D012383:Romania / Q000453:epidemiology; D015996:Survival Rate; D013997:Time Factors
keywords: congenital diaphragmatic hernias; conventional mechanical ventilation; diaphragm embryogenesis; malformations; prenatal diagnosis