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  4. Computed Tomographic Study of the Pediatric Diaphragmatic Growth: Application to the Treatment of Congenital Diaphragmatic Hernia.
 
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Titre

Computed Tomographic Study of the Pediatric Diaphragmatic Growth: Application to the Treatment of Congenital Diaphragmatic Hernia.

Type
article
Institution
Externe
Périodique
European Journal of Pediatric Surgery  
Auteur(s)
Schneider, A.
Auteure/Auteur
Koob, M.
Auteure/Auteur
Sananes, N.
Auteure/Auteur
Senger, B.
Auteure/Auteur
Hemmerlé, J.
Auteure/Auteur
Becmeur, F.
Auteure/Auteur
Liens vers les personnes
Koob, Meriam  
ISSN
1439-359X
Statut éditorial
Publié
Date de publication
2017-04
Volume
27
Numéro
2
Première page
177
Dernière page/numéro d’article
180
Peer-reviewed
Oui
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: ppublish
Résumé
Background The prosthesis commonly used for the treatment of congenital diaphragmatic hernia (CDH) lacks elasticity to replace the diaphragm's mechanical properties and does not follow the natural growth of the child treated. Objective To determine the appropriate properties required for the prostheses, a CT study on healthy patients was conducted. Methods Two methods of diaphragmatic surface analysis are assessed: the diaphragmatic surface is either estimated using surface 2D estimations (method 1), or calculated using length measures on thoracoabdominal CT scans from children (method 2). Patients are divided into two groups depending on their age: group 1: n = 9; median age: 2.0 months (0.1-9.5); group 2: n = 9; median age: 182.6 months (158.5-235.5). Growth factor between the two groups is calculated and the two methods are statistically compared. Results The ratio group 2/group 1 of the diaphragmatic surfaces was 4.3 ± 0.2 on the left side and 4.0 ± 0.2 on the right side for method 1, and 5.1 ± 0.2 on the left side and 5.1 ± 0.3 on the right side for method 2. The difference in the median values between both methods is statistically significant for both the left and right sides (p = 0.022 and p = 0.002, respectively). Hence, the two methods cannot be used exchangeably. Conclusion The treatment of CDH with large defect remains a challenge because of the high incidence of hernia recurrence probably due to prosthesis defect; thus it is important to estimate the diaphragmatic surface precisely. We aim to develop a prosthesis material that can be commonly used and found a mean diaphragmatic growth factor of approximately 4 to 5 from early childhood to adolescence.
Sujets

Adolescent

Diaphragm/anatomy & h...

Diaphragm/diagnostic ...

Diaphragm/growth & de...

Hernias, Diaphragmati...

Humans

Infant

Prostheses and Implan...

Retrospective Studies...

Statistics, Nonparame...

Tomography, X-Ray Com...

PID Serval
serval:BIB_1301DA544AFF
DOI
10.1055/s-0036-1582242
PMID
27065355
WOS
000398466300009
Permalien
https://iris.unil.ch/handle/iris/119561
Date de création
2017-08-28T13:14:41.559Z
Date de création dans IRIS
2025-05-20T20:02:31Z
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