A population-based study of congenital diaphragmatic hernia outcome in New South Wales and the Australian Capital Territory, Australia, 1992-2001

The Prognostic Factors of Congenital Diaphragmatic Hernia Patients and The Evaluation of The Effects of Lung Development With Ventilation-Perfusion Scintigraphy

“…106 olguluk bir çalışmada, C/S ile doğan olgularda sağkalım oranının vajinal yolla doğanlara göre 3 kat daha fazla olduğu saptanmıştır (22) . Bir çalışmada ise, doğum şeklinin sağkalımı etkilemediği saptanmamış-tır (23) . Çalışmamızda, vajinal yolla doğan bebeklerin ölüm oranı hafif yüksek (%54,5) çıksa da normal doğanlar ile sezaryen doğanlar arasında sağkalım açısın-dan istatistiksel olarak anlamlı farklılık saptanmamış-tır.…”

Predictors of Mortality and Morbidity in Infants with CDH

“…Another study identified three independent risk factors for mortality with CDH: low 5-minute Apgar score, prematurity, and air leak. Among these, 5-minute Apgar score was the strongest risk factor (Levison et al, 2006) …”

“…It is associated with significant mortality and morbidity (Abdullah et al, 2009). Survival data for CDH are conflicting; a few centers reported 82% to 93% survival rate (Javid et al, 2004;Grushka et al, 2009;Mettauer et al, 2009) while others had significantly less figures (54%-56%) (Colvin et al, 2005;Levison et al, 2006). This divergence in survival data has been attributed to case selection bias at single tertiary care institutions because as many as 35% of live-born infants with CDH do not survive to transport resulting in a hidden mortality for this condition (Harrison et al, 1978;Colvin et al;, V.K.…”

Congenital Diaphragmatic Hernia: State of the Art Reconstruction- Biologics Versus Synthetics

“…Others continue to dispute such outstanding gains, attributing them both to patient recruitment and a case selection bias at tertiary referral centers (Stege et al, 2004). In contrast, significantly lower survival rates of 54-56% have been reported from population-based studies in the UK and Australia despite their implementation of the same strategy of presurgical stabilization, permissive hypercapnea and gentilation with high frequency ventilator modes (Levison, 2006). Population based studies typically include more nonsurvivors than tertiary referral centers who capture only those who survived to arrival the other caveat is how to best track all those diagnosed prenatally.…”

“…The most commonly used acellular bioprosthetic patches include SurgisisGold (Cook Biotech, Lafayette, IN), Permacol (Tissue Science Laboratories Inc, Andover, Mass), Alloderm (LifeCell Inc, Branchburg, NJ), or recent composites with a synthetic sandwiched as an overlay to a bioprosthetic, such as Gore-tex® and Surgisis®(See Figure 1D) Prior bilayer patches incorporated both Gore-tex® and Marlex® which demonstrated only one recurrence (3.5%) (Riehle et al, 2007) which suggested a benefit of sandwiching a synthetic with a monofilament mesh to induce tissue incorporation. Synthetic patch repairs emerged historically as the predominant method of tension-free closure of defects not amenable to primary repair (Levison et al, 2006). Despite three decades of experience with synthetic patches, which offer a superb short term solution, recurrence rates are reported as high as 41% -46% at a median follow up of 12 months (Moss et al, 2001;Jancelewicz et al, 2010), compared to 10-22% rate following primary closure in long-term survivors (Jancelewicz et al, 2010;Cohen & Reid, 1981).…”