2021 Volume 57 Issue 7 Pages 1071-1077
There are few reports on the application of a silo technique for abdominal wall abnormalities to congenital diaphragmatic hernia (CDH). We selected the silo technique to temporarily expand the intra-abdominal volume in one patient, in which we were able to successfully repair a primary diaphragmatic defect. The patient was a 0-day-old girl. She was born weighing 2,272 g after 37 weeks of gestation. She was diagnosed as having CDH immediately after birth and underwent open surgery on day 4. Many intraperitoneal organs, mainly the liver, had prolapsed into the thoracic cavity. After we pulled out the organs and directly repaired the right diaphragm, the right diaphragm shrank and the intraperitoneal volume decreased. We therefore attempted to expand the intraperitoneal volume using a patch. We next formed a silo on the abdominal wall, aiming for physiological restoration with self-tissue. She generally demonstrated a good postoperative course despite the onset of temporary chylothorax ascites. She was discharged on day 55. We deemed that performing a two-stage surgery with the use of a silo could be a viable option for the treatment of CDH, in which returning the intraperitoneal organs is difficult.
