Prenatally versus postnatally diagnosed congenital diaphragmatic hernia – Side, stage, and outcome

Burgos, Carmen Mesas; Frenckner, Björn; Luco, Matías; Harting, Matthew T.; Lally, Pamela A.; Lally, Kevin P.

doi:10.1016/j.jpedsurg.2018.04.008

Cited by 78 publications

(71 citation statements)

References 19 publications

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“…Second, while the majority were prenatally diagnosed by ultrasound and were asymptomatic at birth, one-third were still initially diagnosed in the postnatal period in spite of the widespread availability and enhanced resolution of ultrasound technologies. This prenatal diagnosis rate is comparable to that recently reported for congenital diaphragmatic hernia [42]. Nevertheless, the true CLM prenatal diagnosis rate may be slightly higher given that some member institutions without well-established fetal care programs may have had difficulty accessing outside hospital maternal records.…”

Section: Accepted Manuscriptsupporting

confidence: 76%

Development of a multi-institutional registry for children with operative congenital lung malformations

Kunisaki

Saito

Fallat

et al. 2020

Journal of Pediatric Surgery

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Introduction: The purpose of this study was to develop a multi-institutional registry to characterize the demographics, management, and outcomes of a contemporary cohort of children undergoing congenital lung malformation (CLM) resection. Methods: After central reliance IRB approval, a web-based, secure database was created to capture retrospective cohort data on pathologically-confirmed CLMs performed between 2009-2015 within a multi-institutional research collaborative. Results: Eleven children's hospitals contributed 506 patients. Among 344 prenatally diagnosed lesions, the congenital pulmonary airway malformation volume ratio was measured in 49.1%, and fetal MRI was performed in 34.3%. One hundred thirty-four (26.7%) children had respiratory symptoms at birth. Fifty-eight (11.6%) underwent neonatal resection, 322 (64.1%) had surgery at 1-12 months, and 122 (24.3%) had operations after 12 mos. The median age at resection was 6.7 months (interquartile range, 3.6-11.4). Among 230 elective lobectomies performed in asymptomatic patients, thoracoscopy was successfully utilized in 102 (44.3%), but there was substantial variation across centers. The most common lesions were congenital pulmonary airway malformation (n=234, 47.3%) and intralobar bronchopulmonary sequestration (n=106, 21.4%). Conclusion: This multicenter cohort study on operative CLMs highlights marked disease heterogeneity and substantial practice variation in preoperative evaluation and operative management. Future registry studies are planned to help establish evidencebased guidelines to optimize the care of these patients.

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Section: Accepted Manuscriptsupporting

confidence: 76%

Development of a multi-institutional registry for children with operative congenital lung malformations

Kunisaki

Saito

Fallat

et al. 2020

Journal of Pediatric Surgery

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“…The most recent study from the CDHSG on 3,746 cases of CDH managed between 2007 and 2015 has shown that the need for ECMO in this cohort of patients was 29%. 22 The low use of ECMO in our study could be explained by different factors. As the NSQIP database records the use of ECMO only in the 7 days prior to surgery, a proportion of patients may have not been captured.…”

mentioning

confidence: 70%

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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“…Para o diagnóstico diferencial da apresentação tardia, os exames de imagem tornam-se importantes, tal qual no caso exposto, que teve como hipóteses iniciais a broncopneumonia ou aspiração de corpo estranho, sobretudo a radiografia contrastada e a tomografia de tórax, pois complementam o estudo de uma condição menos comum. 12 De acordo com os dados de Bagłaj, 13 a precisão diagnóstica com a radiografia de tórax chega a 49% e o encontro de alças intestinais com ar, por vezes com níveis hidroaéreos e desvio do mediastino, são sinais típicos de HDC ao raio X. 13,14 a origem costal e esternal do diafragma e representam apenas 1 a 2% das HDC.…”

Section: Discussionunclassified

Hérnia diafragmática congênita com manifestação tardia: relato de caso

Af¹,

Nascimento²,

Carvalho³

2018

Rev Ped SOPERJ

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Introdução: a hérnia diafragmática congênita é caracterizada pela formação incompleta do diafragma e sua incidência neonatal é cerca de 1:3.000 a 1:5.000 nascidos vivos. Cerca de 90% dos pacientes apresentam disfunção respiratória nas primeiras 24 horas de vida. Objetivo: enfatizar a importância do diagnóstico precoce, estabelecido primordialmente durante o pré-natal, para uma conduta terapêutica adequada e demonstrar a importância dos exames de imagem para o diagnóstico em casos de manifestação tardia. Descrição do caso: lactente de 5 meses deu entrada em uma emergência localizada na zona agreste de Pernambuco, apresentando dispneia súbita, irritabilidade e gemência. A radiografia de tórax demonstrou dilatação do brônquio fonte esquerdo, que sugeriu aspiração de corpo estranho. O lactente foi transferido para um hospital de referência para realização de broncoscopia, sendo admitido com estado geral grave, importante desconforto respiratório e queda da saturação de oxigênio. A equipe médica solicitou de urgência uma tomografia de tórax cujo resultado foi sugestivo de hérnia diafragmática. Em seguida, o lactente foi submetido à videotoracoscopia para correção do defeito congênito, através da herniorrafia diafragmática. O lactente evoluiu com evidente melhora do desconforto respiratório após o procedimento, recebendo alta hospitalar no terceiro dia do pós-operatório. Discussão: a hérnia diafragmática congênita com manifestação tardia pode ter apresentação clínica variável o que dificulta o seu pronto-diagnóstico e aumenta as chances de complicações. Para o diagnóstico diferencial, os exames de imagem tornam-se importantes, sobretudo a radiografia contrastada e a tomografia computadorizada de tórax, pois complementam o estudo de uma condição menos comum.

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Prenatally versus postnatally diagnosed congenital diaphragmatic hernia – Side, stage, and outcome

Cited by 78 publications

References 19 publications

Development of a multi-institutional registry for children with operative congenital lung malformations

Development of a multi-institutional registry for children with operative congenital lung malformations

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

Hérnia diafragmática congênita com manifestação tardia: relato de caso

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