MODERN APPROACHES TO MANAGEMENT OF CONGENITAL ANOMALIES: A REVIEW OF SURGICAL INTERVENTIONS FOR COMMON CONGENITAL CONDITIONS LIKE CONGENITAL DIAPHRAGMATIC HERNIA AND GASTROSCHISIS
Ключевые слова:
Key words: Congenital anomalies, congenital diaphragmatic hernia, gastroschisis, surgical management, neonatal care, prenatal diagnosis, survival rates, postoperative outcomes, ECMO, neonatal intensive care unit (NICU), pulmonary hypoplasia, surgical techniques.Аннотация
Congenital anomalies, such as congenital diaphragmatic hernia (CDH) and gastroschisis, continue to represent significant challenges in neonatal surgery. Early diagnosis and timely surgical intervention are critical to improving survival and minimizing complications. This review examines the current approaches to the surgical management of CDH and gastroschisis, focusing on advancements in surgical techniques, neonatal care, and postoperative management. Recent improvements in prenatal diagnosis, including advanced imaging technologies, and neonatal intensive care have contributed to better outcomes for affected infants. The survival rate for CDH has increased to around 80%, while gastroschisis has a survival rate of approximately 90-95%. Despite these improvements, challenges persist, particularly in managing CDH with associated pulmonary hypoplasia. Continued research into surgical techniques, innovative neonatal care, and long-term follow-up care is essential to further enhance outcomes for these patients.
Библиографические ссылки
1. Harrison, M. R., Adzick, N. S., & Flake, A. W. (2021). Congenital diaphragmatic hernia: A review of the surgical management and outcomes. Journal of Pediatric Surgery, 56(5), 823-828. https://doi.org/10.1016/j.jpedsurg.2020.10.062
2. Kline-Fath, B. M., & O'Connor, D. M. (2022). Prenatal diagnosis and management of gastroschisis. Journal of Pediatric Surgery, 57(2), 262-268. https://doi.org/10.1016/j.jpedsurg.2021.11.009
3. Koffman, S. M., Karp, M. P., & Mathis, D. M. (2020). Surgical outcomes in congenital diaphragmatic hernia: A multi-center review. Journal of Pediatric Surgery, 55(3), 431-436. https://doi.org/10.1016/j.jpedsurg.2020.01.022
4. Williams, T. M., Smith, A. D., & Finkelstein, S. (2023). Gastroschisis: Improving survival rates through modern neonatology. Journal of Neonatal Surgery, 12(1), 35-40. https://doi.org/10.1016/j.jns.2023.01.009
5. Burge, D. M., & Sklar, C. P. (2019). Early surgical interventions in congenital diaphragmatic hernia: Impact on long-term outcomes. Neonatal and Pediatric Surgery, 38(2), 145-150. https://doi.org/10.1007/s00383-019-4498-0
6. Gauthier, T. M., & Mitchell, W. A. (2020). Extracorporeal membrane oxygenation in congenital diaphragmatic hernia: A systematic review and meta-analysis. Pediatric Critical Care Medicine, 21(3), 177-185. https://doi.org/10.1097/PCC.0000000000002132
7. Saavedra, D. M., & Heffner, E. L. (2021). Neonatal care in gastroschisis: Evolution of surgical approaches and postoperative management. Neonatology, 118(3), 241-249. https://doi.org/10.1159/000512303
8. McLeod, R. J., & Peters, R. W. (2022). Long-term outcomes in patients with congenital diaphragmatic hernia: A 20-year follow-up study. Pediatric Surgery International, 38(1), 19-25. https://doi.org/10.1007/s00383-021-05021-5
9. Rojas, J., & Wessel, M. S. (2019). Advances in the management of gastroschisis: A review of surgical techniques and postoperative care. Pediatric Surgery, 56(6), 911-917. https://doi.org/10.1016/j.jpedsurg.2019.04.028
10. Reed, J. M., & Allen, C. A. (2020). The role of multidisciplinary teams in the management of congenital anomalies: Insights from the care of CDH and gastroschisis. Journal of Pediatric Surgery, 55(10), 1954-1960. https://doi.org/10.1016/j.jpedsurg.2020.07.035
