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Neonatal Surgical Conditions: Congenital Diaphragmatic Hernia and Short Bowel Syndrome

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Emerging Topics and Controversies in Neonatology

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Abstract

The dramatic improvements in the outcomes of neonatal surgery are due largely to advances in neonatal care and in that sense, all directly of interest to the neonatologist. However there are areas where our understanding of the factors affecting outcomes is still evolving and are therefore areas of intense research. The conditions we have chosen to discuss are those where optimum medical management is the outcome determinant and surgery itself is secondary. These are congenital diaphragmatic hernia and short bowel syndrome.

It is now fairly clear that the main pathophysiological determinant of outcome is the lung maldevelopment associated with congenital diaphragmatic hernia (CDH). Current post-natal management strategies are aimed at reducing any further lung damage and reducing the impact of associated circulatory disturbance. In this section we will seek to clarify the evidence for antenatal intervention, current ventilatory strategy, management of pulmonary hypertension, the role of ECMO and the timing of surgery.

The most common cause of intestinal failure especially in the neonate, is loss of intestinal length. The management and expected outcomes of this condition are very different currently than they were only a few years ago. In this section we shall convey a sense of the current management and outcomes of short bowel syndrome including the indications and outcomes of transplant surgery.

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Authors and Affiliations

  1. Paediatric Surgery, Evelina Childrens Hospital, London, UK

    Yew-Wei Tan

  2. Neonatology, Leicester Royal Infirmary, Leicester, UK

    Andrew Currie

  3. Paediatric Surgery, Leicester Royal Infirmary, Leicester, UK

    Bala Eradi

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  1. Yew-Wei Tan
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  2. Andrew Currie
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  3. Bala Eradi
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Correspondence to Bala Eradi .

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Editors and Affiliations

  1. Department of Health Sciences, George Davies Centre for Medicine, University of Leicester, Leicester, UK

    Elaine M. Boyle

  2. Department of Health Sciences, George Davies Centre for Medicine, University of Leicester, Leicester, UK

    Jonathan Cusack

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Tan, YW., Currie, A., Eradi, B. (2020). Neonatal Surgical Conditions: Congenital Diaphragmatic Hernia and Short Bowel Syndrome. In: Boyle, E., Cusack, J. (eds) Emerging Topics and Controversies in Neonatology. Springer, Cham. https://doi.org/10.1007/978-3-030-28829-7_8

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