Factors associated with early recurrence after congenital diaphragmatic hernia repair

Putnam, Luke R.; Gupta, Vikas; Tsao, KuoJen; Davis, Carl; Lally, Pamela A.; Lally, Kevin P.; Harting, Matthew T.

doi:10.1016/j.jpedsurg.2017.03.011

Cited by 65 publications

(56 citation statements)

References 14 publications

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“…29 In our cohort of patients, we detected a postoperative complication rate comparable to the one reported in the literature. We observed an "in hospital" hernia recurrence rate similar to that reported by the CDHSG 30 and by the Japanese CDH study group. 31 Moreover, in our cohort we found a rate of central line associated blood stream infections of 4%, that is similar to the 9% reported in a study from the Children's Hospital Neonatal Database on 572 infants with CDH.…”

supporting

confidence: 89%

First Population-Based Report of Infants with Congenital Diaphragmatic Hernia: 30-Day Outcomes from the American College of Surgeons National Quality Improvement Program

et al. 2018

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supporting

confidence: 89%

First Population-Based Report of Infants with Congenital Diaphragmatic Hernia: 30-Day Outcomes from the American College of Surgeons National Quality Improvement Program

et al. 2018

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“…The recurrence rate of CDH notruedefect within 1 year was higher than in previous statements, where no recurrences in CDE were reported [7,[19][20][21][22]. Then again, the total number of recurrences found in the Bochdalek type CDH in this cohort (5%) is relatively low in comparison to other studies, and the sample sizes of both eventration and hernia sac patients are relatively small [8,24]. Previous studies suggested that the severity or defect size of CDH would be a prognostic value for recurrence rates [24][25][26][27], but these cohorts were not adjusted for CDE and CDH with hernia sacs.…”

Section: Discussioncontrasting

confidence: 53%

“…Then again, the total number of recurrences found in the Bochdalek type CDH in this cohort (5%) is relatively low in comparison to other studies, and the sample sizes of both eventration and hernia sac patients are relatively small [8,24]. Previous studies suggested that the severity or defect size of CDH would be a prognostic value for recurrence rates [24][25][26][27], but these cohorts were not adjusted for CDE and CDH with hernia sacs. The current study shows that during follow-up of the surviving patients, patients with no true defects have a higher recurrence rate than patients with a true defect.…”

Section: Discussionmentioning

confidence: 64%

Congenital diaphragmatic eventration and hernia sac compared to CDH with true defects: a retrospective cohort study

et al. 2020

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Congenital diaphragmatic eventration (CDE) and congenital diaphragmatic hernia (CDH) with or without hernia sac are three different types of congenital diaphragmatic malformations, which this study evaluates. All surgically treated patients with CDE or Bochdalek type CDH between 2000 and 2016 were included in this retrospective analysis. Demographics, CDH-characteristics, treatment, and clinical outcome were evaluated. In total, 200 patients were included. Patients with an eventration or hernia sac had no significant differences and were compared as patients without a true defect to patients with a true defect. The 1-year survival of patients with a true defect was significantly lower than patients with no true defect (76% versus 97%, p = 0.001). CDH with no true defect had significantly better short-term outcomes than CDH with true defect requiring patch repair. However, at 30 days, they more often required oxygen supplementation (46% versus 26%, p = 0.03) and had a higher recurrence rate (8% versus 0%, p = 0.006) (three eventration and two hernia sac patients). Conclusion: Patients without a true defect seem to have a more similar clinical outcome than CDH patients with a true defect, with a better survival. However, the recurrence rate and duration of oxygen supplementation at 30 days are higher than CDH patients with a true defect. What is Known:• Congenital diaphragmatic hernia with or without hernia sac and congenital diaphragmatic eventration (incomplete muscularization) are often treated similarly. • Patients with hernia sac and eventration are thought to have a relatively good outcome, but exact numbers are not described. What is New: • Congenital diaphragmatic eventration and patients with hernia sac seem to have a more similar clinical outcome than Bochdalek type CDH with a true defect. • Patients without a true defect (eventration or hernia sac) have a high recurrence rate.

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“…22 However, recent data also suggest that the minimally invasive approach itself may be associated with increased recurrence rates. 23 The CDH Study Group analyzed 4,390 patients and compared open (97%) versus MIS (3%) CDH repair. They determined a significantly increased odds ratio for recurrence in the MIS cohort (odds ratio: 3.59; 95% confidence interval: 1.92-6.71).…”

Section: Recurrence Ratementioning

confidence: 99%

Thoracoscopic Repair of Congenital Diaphragmatic Hernia

Wagner

Mayer

et al. 2020

Eur J Pediatr Surg

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The surgical management of patients with congenital diaphragmatic hernia (CDH) is challenging and ever changing. It requires the highest expertise not only on the surgical level but also of neonatologists and anesthesiologists. In selected patients traditional open surgery is increasingly replaced by thoracoscopic CDH repair in many centers worldwide. Despite obvious and well-described advantages of the minimally invasive approach like a shorter ventilatory time, less pain, a shorter hospital length of stay, and a better cosmesis, important controversies remain. This review discusses hot topics of minimally invasive CDH repair, such as extracorporeal membrane oxygenation, hypercapnia/acidosis, patch repair, surgical training, and recurrence.

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Factors associated with early recurrence after congenital diaphragmatic hernia repair

Cited by 65 publications

References 14 publications

First Population-Based Report of Infants with Congenital Diaphragmatic Hernia: 30-Day Outcomes from the American College of Surgeons National Quality Improvement Program

First Population-Based Report of Infants with Congenital Diaphragmatic Hernia: 30-Day Outcomes from the American College of Surgeons National Quality Improvement Program

Congenital diaphragmatic eventration and hernia sac compared to CDH with true defects: a retrospective cohort study

Thoracoscopic Repair of Congenital Diaphragmatic Hernia

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