The primary therapeutic target of congenital diaphragmatic hernia (CDH) patients has shifted from emergency surgical repair towards a non-operative emergency of the newborn treated by interdisciplinary teams. The increased understanding of the epidemiological and pathophysiological aspects of CDH have lead to an improved knowledge and application of prenatal diagnosis, postnatal ventilation strategies, treatment of associated pulmonary hypertension and the role of extracorporeal membrane oxygenation therapy. In the surgical field, the perspectives have changed with delayed CDH repair, the introduction of minimally invasive surgery and use of prosthetic material for closure of large defects. With decreased mortality, long-term multi-organ morbidity has increased in some survivors. In the near future, randomized controlled trials on different aspects of therapy will determine evidence-based optimal care.

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The studies described in this thesis have been financially supported by the Sophia Foundation for Scientific Research (SSWO project # 521)
D. Tibboel (Dick) , I.K.M. Reiss (Irwin)
Erasmus University Rotterdam
Erasmus MC: University Medical Center Rotterdam

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