Surgical conditions of the diaphragm: posterior diaphragmatic hernias in infants.

The care of the neonate with CDH has significantly evolved from an approach characterized by aggressive ventilation and emergency surgical repair, to the current use of permissive hypercapnea, physiologic stabilization, elective surgical repair, and multidisciplinary follow-up. Overall survival now approaches 80%, but this improvement has been associated with increased recognition of respiratory, cardiac, gastrointestinal, and neurodevelopmental morbidity. Topics of continuing controversy in the management of CDH include the value of fetal tracheal occlusion, the expanding role of ECMO, and the use of minimal access techniques for surgical repair.