Abstract：
:The most popular techniques for repairing large diaphragmatic defects involve the use of synthetic patches. We present an alternative approach using living tissue. We reviewed our cases of congenital diaphragmatic hernia (CDH) diagnosed within the first 24 h of life from 1991 to 2003. Toldt's fascia (TF) flap was used to repair defects that were too large to repair primarily even though the anterior rim of the diaphragm was present. After confirming that a small medial muscle remnant of the diaphragm was present, its mesothelial covering was incised, and the incision was extended to the TF far enough to create a flap sufficiently large to repair the defect. The TF flap, consisting of the small medial muscle remnant, TF, peritoneum, and retroperitoneal connective tissue, was mobilized carefully from the ipsilateral kidney and adrenal gland, and the repair completed with interrupted sutures using nonabsorbable material. We used this TF flap approach in seven of 43 patients with CDH. Two had right-sided CDH. Six survived. The mean size of the diaphragmatic defects in the seven TF flap cases was 5.43+/-0.53 x 3.86+/-1.07 cm, which was significantly larger than the defects in direct primary repair cases (3.40+/-0.77 x 2.03+/-0.59 cm) (p<0.01). The six survivors had good outcomes, and none of them have had recurrence of herniation or required any additional surgical intervention (mean follow-up period: 4.7 years). To the best of our knowledge, this is the first report of TF being used to repair large diaphragmatic hernias. Our technique is simple and has proven to be reliable for durable restoration of the diaphragm, suggesting that it could reduce the dependence on synthetic patch repair, which is associated with certain long-term complications.
journal_name
Pediatr Surg Intjournal_title
Pediatric surgery internationalauthors
Okazaki T,Hasegawa S,Urushihara N,Fukumoto K,Ogura K,Minato S,Kawashima S,Kohno Sdoi
10.1007/s00383-004-1267-7subject
Has Abstractpub_date
2005-01-01 00:00:00pages
64-7issue
1eissn
0179-0358issn
1437-9813journal_volume
21pub_type
杂志文章abstract：:A new instrument for suction rectal biopsy in infants suspected of having Hirschsprung's disease is described that can be completely dismantled, physically cleaned, lubricated, and heat-sterilised. These attributes are new and are absolutely critical today. The instrument has been used in 60 patients (ca. 180 biopsies...
journal_title：Pediatric surgery international
pub_type： 杂志文章
doi：10.1007/BF01194812
更新日期：1997-01-01 00:00:00
abstract：PURPOSE:Hirschsprung disease (HSCR) has previously been associated with increased mortality. The aim of this study was to assess mortality in patients with Hirschsprung disease in a population-based cohort. METHODS:This was a nationwide, population-based cohort study. The study exposure was HSCR and the study outcome ...
journal_title：Pediatric surgery international
pub_type： 杂志文章,多中心研究
doi：10.1007/s00383-017-4150-z
更新日期：2017-11-01 00:00:00
abstract：PURPOSE:Megacystis microcolon intestinal hypoperistalsis syndrome (MMIHS) is a rare and the most severe form of functional intestinal obstruction in the newborn. This congenital condition is associated with non-obstructed urinary bladder, microcolon and decreased or absent intestinal peristalsis. This study was designe...
journal_title：Pediatric surgery international
pub_type： 杂志文章,评审
doi：10.1007/s00383-011-2954-9
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journal_title：Pediatric surgery international
pub_type： 杂志文章
doi：10.1007/s00383-015-3664-5
更新日期：2015-03-01 00:00:00
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journal_title：Pediatric surgery international
pub_type： 杂志文章
doi：10.1007/s00383-003-0989-2
更新日期：2003-11-01 00:00:00
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journal_title：Pediatric surgery international
pub_type： 杂志文章
doi：10.1007/s00383-018-4409-z
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journal_title：Pediatric surgery international
pub_type： 杂志文章
doi：10.1007/s003830050593
更新日期：1999-07-01 00:00:00
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journal_title：Pediatric surgery international
pub_type： 杂志文章
doi：10.1007/s003830050623
更新日期：1999-07-01 00:00:00
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journal_title：Pediatric surgery international
pub_type： 杂志文章
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更新日期：2010-12-01 00:00:00
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journal_title：Pediatric surgery international
pub_type： 杂志文章,评审
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更新日期：2008-10-01 00:00:00
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journal_title：Pediatric surgery international
pub_type： 杂志文章
doi：10.1007/s00383-005-1481-y
更新日期：2005-08-01 00:00:00
abstract：:At bilateral orchiopexy bilateral biopsies may be indicated to determine fertility potential. It is currently unknown if the serum inhibin B levels at time of orchiopexy reflect the testicular status of the bilaterally cryptorchid child. The aim of this study was to relate the results of inhibin B and FSH measurements...
journal_title：Pediatric surgery international
pub_type： 杂志文章
doi：10.1007/s00383-006-1839-9
更新日期：2007-02-01 00:00:00
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journal_title：Pediatric surgery international
pub_type： 杂志文章
doi：10.1007/s00383-014-3550-6
更新日期：2014-10-01 00:00:00
abstract：:Anterior sagittal anorectoplasty (ASARP) was used for the definitive correction in 107 cases of anovestibular fistula (AVF) between 1996 and 2005. These cases were subjected to three different types of treatment regimes during the same period. Majority of the cases (78) were operated in one stage where postoperatively...
journal_title：Pediatric surgery international
pub_type： 杂志文章
doi：10.1007/s00383-007-2019-2
更新日期：2007-12-01 00:00:00
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journal_title：Pediatric surgery international
pub_type： 杂志文章
doi：10.1007/s00383-009-2431-x
更新日期：2009-09-01 00:00:00
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journal_title：Pediatric surgery international
pub_type： 杂志文章
doi：10.1007/s00383-002-0831-2
更新日期：2002-12-01 00:00:00
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journal_title：Pediatric surgery international
pub_type： 杂志文章
doi：10.1007/s00383-006-1722-8
更新日期：2006-08-01 00:00:00
abstract：:Fertility in patients treated for unilateral testicular torsion has been shown to be significantly reduced in all the reported series to date, implying that the present-day treatment requires further refinement in the form of adjunct pharmacotherapeutic intervention (Lomodex and MgSO(4)) in addition to scrotal explora...
journal_title：Pediatric surgery international
pub_type： 杂志文章
doi：10.1007/s00383-004-1317-1
更新日期：2005-03-01 00:00:00
abstract：PURPOSE:For International Neuroblastoma Staging System (INSS) stages III or IV neuroblastoma (intermediate or high risk), complete excision of the primary tumor is not always feasible. Most current studies on the treatment outcome of these patients have reported on the complete excision status. The aim of this study is...
journal_title：Pediatric surgery international
pub_type： 杂志文章
doi：10.1007/s00383-009-2417-8
更新日期：2009-09-01 00:00:00
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journal_title：Pediatric surgery international
pub_type： 杂志文章
doi：10.1007/s00383-011-2912-6
更新日期：2011-11-01 00:00:00
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journal_title：Pediatric surgery international
pub_type： 杂志文章,评审
doi：10.1007/s00383-007-2045-0
更新日期：2008-02-01 00:00:00
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journal_title：Pediatric surgery international
pub_type： 杂志文章
doi：10.1007/s00383-009-2411-1
更新日期：2009-08-01 00:00:00
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journal_title：Pediatric surgery international
pub_type： 杂志文章,多中心研究
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更新日期：2013-12-01 00:00:00
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journal_title：Pediatric surgery international
pub_type： 杂志文章,多中心研究
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更新日期：2018-02-01 00:00:00
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journal_title：Pediatric surgery international
pub_type： 杂志文章
doi：10.1007/s003830050038
更新日期：2000-01-01 00:00:00
abstract：:This review gives an overview of the disease spectrum of congenital diaphragmatic hernia (CDH). Etiological factors, prenatal predictors of survival, new treatment strategies and long-term morbidity are described. Early recognition of problems and improvement of treatment strategies in CDH patients may increase surviv...
journal_title：Pediatric surgery international
pub_type： 杂志文章,评审
doi：10.1007/s00383-009-2425-8
更新日期：2009-09-01 00:00:00
abstract：:Accessory hepatic tissue, unlike accessory splenic and pancreatic tissue, is rare and has a limited and almost exclusively sub diaphragmatic distribution. Fewer than ten cases of intrathoracic ectopic liver have been reported so far in the literature. This paper reports a case that caused a diagnostic dilemma. ...
journal_title：Pediatric surgery international
pub_type： 杂志文章,评审
doi：10.1007/s003830000520
更新日期：2001-07-01 00:00:00
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journal_title：Pediatric surgery international
pub_type： 杂志文章
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更新日期：2017-03-01 00:00:00
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journal_title：Pediatric surgery international
pub_type： 杂志文章
doi：10.1007/s00383-011-3039-5
更新日期：2012-03-01 00:00:00
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journal_title：Pediatric surgery international
pub_type： 杂志文章
doi：10.1007/s003830050603
更新日期：1999-07-01 00:00:00
