Recently, a multidisciplinary team (MDT) from the Department of Pediatric Surgery, Department of Neonatology and Department of Obstetrics at the First Affiliated Hospital (FAH) of Xi’an Jiaotong University (XJTU) worked in close collaboration to successfully perform reduction of herniated abdominal organs and diaphragmatic repair for a newborn only one day old who had been diagnosed with congenital diaphragmatic hernia. After surgery, the infant’s vital signs remained stable, the baby was successfully weaned from the ventilator, and has now recovered and been discharged from hospital.

During a prenatal examination at the FAH of XJTU, Ms. Wei (pseudonym) was informed that the fetus might have congenital diaphragmatic hernia (CDH), a condition with an incidence of about 1 in 3,000 to 5,000 and an extremely high risk of death after birth due to compression of the heart and lungs by the abdominal organs. Before the establishment of the FAH’s multidisciplinary center, the mortality rate in such infants was as high as 67%, which has dropped to 23% since its establishment. Led by Zhou Xihui, Director of the Department of Pediatrics and Cao Zhenjie, Director of the Department of Pediatric Surgery, and in collaboration with teams from the Departments of Obstetrics and Anesthesiology, a detailed delivery and treatment plan was rapidly developed, neonatal ventilators and resuscitation equipment were prepared in advance, and the entire rescue chain was moved forward.

Immediately after birth, the baby developed severe respiratory distress. The neonatology team rapidly performed endotracheal intubation on the delivery table to establish effective ventilation, and the infant was then transferred to the neonatal unit for hemodynamic stabilization. At 24 hours after birth, imaging revealed that a large portion of the spleen and intestines remained herniated into the thoracic cavity, posing an imminent risk of bowel strangulation. In accordance with clinical guidelines, the pediatric surgery team decided to perform minimally invasive thoracoscopic repair. During the operation, Director Cao Zhenjie’s team carried out precise maneuvers in a very limited space, gently reducing the herniated abdominal organs back into the abdominal cavity. Given the large diaphragmatic defect, a biological patch was used to reinforce and repair the diaphragm. With continuous support from the anesthesiology and nursing teams, the procedure was successfully completed. Postoperatively, the infant’s lung function gradually recovered, and the baby was successfully weaned from the ventilator.