Universitätsmedizin Mannheim (UMM) provides Extra-Corporal Membrane Oxygenation (ECMO) since 1987 and more than 700 ECMO-runs have been performed. Since 15 years at least 50 patients with CDH (congenital diaphragmatic hernia) are treated annually in our hospital. Patients with CDH come from all over Germany, German speaking and further European countries for treatment to Mannheim. Due to our longtime expertise survival is surpassed by more than 80%, while in most countries survival is between 40-60%. Relapses of CDH are more seldom than in other centres, so expertise in diaphragm repair may be shared.
Etiology for short bowel syndrome with intestinal failure are NEC (necrotizing enterocolitis), abdominal wall defects with and without atresia and/or ischaemia (volvulus), Zülzer-Wilson-Syndrome (total colonic and small bowel aganglionosis). Theses conditions lead to dilation of small bowel with bacterial overgrowth, malabsorbtion and maldisgestion with need for parenteral nutrition and risk for septicaemia. In short bowel syndrome several lengthening and tapering procedures have been provided since 1991 and more than 100 patients have been treated up to now. Expertise is shared with other centres all over Europe.
All other congenital malformations are treated in our hospital in cooperation with the departments of neonatology and pediatrics. In Esophageal Atresia esophageal stenting and substitutes are provided. Because ECMO as a substitute for ventilation may be offered, yearly 5-10 babies with Congenital Pulmonary Airway Malformations (CPAM) are treated in the neonatological department and the need for surgical procedures, especially resection of the affeczed lung is discussed in a multidisciplinary setting.
For the treatment of Hirschsprung's disease all commonly accepted and recommended diagnostic and therapeutic procedures are offered. In Aganglionosis there is a lack of neuronal cells (ganglia), that are necessary for relaxation of the muscular layer of the rectum in order to enable defecation. Normally the affected colon is resected. For the future it might be possible to treat Hirschsprung's disease with stem cells, that did not reach the rectum during fetal growth. Stem cell research is performed at our department.