Paediatric Surgery (Ukraine). 2026. 2(91): 60-68. doi: 10.15574/PS.2026.2(91).6068
Sliepov O. K., Danilov O. A., Sliepov Ie. O.
Center for neonatal surgery for malformations and their rehabilitation of SI «Ukrainian center of мaternity and childhood of the NAMS of Ukraine», Kyiv

For citation: Sliepov OK, Danilov OA, Sliepov IeO. (2026). Surgical treatment of congenital diaphragmatic hernias in children older than 1 month. Paediatric Surgery (Ukraine). 2(91): 60-68. doi: 10.15574/PS.2026.2(91).6068.
Article received: Mar 18, 2026. Accepted for publication: Jun 15, 2026.

Aim – to analyze the clinical and anatomical characteristics of the defect, the choice of surgical approach, and methods for repairing diaphragmatic defects in order to optimize the strategies and techniques for the surgical treatment of congenital diaphragmatic hernias (CDH) diagnosed in children older than 1 month of age.
Materials and methods. A retrospective study was conducted on the treatment outcomes of 28 children aged 1.5 months to 13 years with late-diagnosed CDH: 21 with Bochdalek hernias (BH) and 7 with Morgagni hernias (MH). We analyzed the location and anatomical features of the hernial defect, the presence of a hernial sac and associated congenital anomalies, the choice of surgical approach, the diaphragmatic repair technique, the course of the postoperative period, complications, recurrences, and treatment outcomes.
Results. All patients underwent open surgery using thoracotomy or laparotomy,. In all cases, the defect was repaired using local tissues. For MH and noncommunicating BH, the hernial sac was removed; in the absence of a posterior muscular ring of the defect, the anterior edge of the diaphragm was fixed to a rib or the costal arch. In cases of combined defects, simultaneous procedures were performed. An intraoperative complication occurred in 1 (4.7%) case; no postoperative complications or recurrences were observed. All children achieved good functional outcomes and 100% survival.
Conclusions. Late-diagnosed CDH requires an individualized approach to the selection of surgical tactics depending on the type of hernia and the anatomy of the defect. Open access and repair of the defect using local tissues ensure high treatment efficacy, absence of recurrences, and good functional outcomes. The proposed surgical treatment strategy can be recommended for children with CDH diagnosed after the neonatal period.
The study was conducted in accordance with the principles of the Declaration of Helsinki. The informed consent of the patients was obtained for conducting the studies.
The authors declare no conflict of interest.
Keywords: children, congenital diaphragmatic hernia, Bochdalek hernia, Morgagni hernia, surgical treatment, diaphragmatic repair.

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