Congenital diaphragmatic Hernia case study

Document Type:Case Study

Subject Area:Nursing

Document 1

In most cases, this syndrome usually occurs on the left side of the diaphragm (Leeuwen, 112-114). The effect of incomplete formation of the diaphragm is that it leads to free passage of abdominal viscera to the thorax. There is also usually a displacement of the mediastinum. The displacement happens at the contralateral side and this causes hypoplasia of the lungs which leads to arteries becoming abnormal and leads to pulmonary hypertension. This has life-threatening consequences to the neonate at birth as cardiovascular and respiratory functions are usually compromised right after birth. There is, however, a lack of studies that compare the two surgical interventions (Tyson, 1209-1216). Presentation of the problem The minimally invasive surgery has slowly become the preferred treatment of choice in the treatment of congenital diaphragmatic Hernia (Zahn, 1418-1424.

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There has not been conclusive evidence on data that minimally invasive surgery is more beneficial compared to the open surgical treatment. The study seeks to examine data related to various care aspects including admission and discharge after the neonate was diagnosed with CDH. Explanation of the terms CDH-Congenital Diaphragmatic Hernia; CDH condition wherein the part of the intestines are in the thoracic cavity, therefore, impeding the ventilation Tradition Open Approach- Laparotomy /Thoracotomy Minimal Invasive Surgery (MIS) - the use of scopes in performing surgery by having small incisions on the thorax or abdominal cavity, e. Furthermore, the surgical management through the aid of repairing the defect is one part of the solution to the multitude of dilemma brought about the defect, though surgical advances and approaches are being discovered and improved one cannot say the best approach.

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Methods of data collection Data used in the case study was sourced from various sources from the internet including journals and articles related to CHD. The studies found were sorted out by the relevance of 5 years to promote relevancy of the study. Presentation of the data Traditional open surgery has been a widely practiced and known technique in the repair of CHD. The most significant benefits to the neonates are usually achieved when the Minimal Invasive procedure is used. Second is thoracotomy which is an incision on the thorax that is very useful in the recurrence of repair. There is another advantage in the sense that thorax is rapidly emptied and the surgeon has a better view of the diaphragm just like the first approach it has its downsides like the bowel are not inspected, severe reduction and the learning curve will take up the surgeon time.

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Even though other approaches are being sometimes practiced the well-experienced doctor preferred these techniques and none of this has not shown a definite cut above from the other. Argument II In progressive studies on CDH other technique that has been developed is the MIS (Minimal Invasive Surgery) which is being utilized in the current era. Though in the previous studies the criteria for this technique is limited to the patients with minimal ventilatory support, without evidence of pulmonary hypertension and the stomach being in the abdomen but with this control of pain is more magnificent and with less risk of adhesions. Therefore the approaches and techniques may vary, but the question of lung maturity is still in the air and proving proper oxygenation is the primary concern. Concluding statement The approaches being in question do not make the difference in the management of congenital diaphragmatic Hernia though recurrence might still occur.

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Recommendation New approaches in dealing with CDH surgically and continuously emerging the researchers still recommend review and studies should be imposed for us to determine the correct and most beneficial to the patient. References Zhu, Y. et al. van Mieghem, Tim, et al. Congenital Diaphragmatic Hernia. Obstetric Imaging: Fetal Diagnosis and Care (Second Edition). Zalla, Jennifer M. Gregory J. Single-staged surgical approach in congenital diaphragmatic hernia associated with esophageal atresia. Journal of pediatric surgery 50.

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