Pediatr Surg Int. 2019 May 14. doi: 10.1007/s00383-019-04484-3. [Epub ahead of print]
https://www.ncbi.nlm.nih.gov/pubmed/31089883
Outcomes of infants with congenital diaphragmatic hernia by side of defect in the FETO era.
Ali K1, Dassios T1,2, Khaliq SA1, Williams EE2, Tamura K1,3, Davenport M4, Greenough A5,6,7,8.
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Abstract
PURPOSE:
To compare the outcomes of infants with a right (RCDH) versus a left-sided (LCDH) congenital diaphragmatic hernia (CDH) and whether these differed according to whether the infants had undergone fetoscopic tracheal occlusion (FETO).
METHODS:
Demographics, the type of surgical repair, preoperative and postoperative courses and respiratory, gastrointestinal, surgical and skeletal morbidities at follow-up were compared between infants with a RCDH or LCDH. A sub-analysis was undertaken in those who had undergone FETO.
RESULTS:
During the study period, there were 167 infants with a LCDH and 24 with a RCDH; 106 underwent FETO (15 RCDH). Overall, the need for inhaled nitric oxide (p = 0.036) was higher in the RCDH group and, at follow-up, infants with RCDH were more likely to have a hernia recurrence (p = 0.043), pectus deformity (p = 0.019), scoliosis (p = 0.029) and suffer chronic respiratory morbidity (p = 0.001). There were, however, no significant differences in short term or long term outcomes (hernia recurrence (p = 0.237), pectus deformity (p = 0.322), scoliosis (p = 0.0174) or chronic respiratory morbidity (p = 0.326)) between infants with a right or left sided CDH who had undergone FETO.
CONCLUSION:
Overall, infants with a RCDH compared to those with a LCDH had greater long-term morbidity, but not if they had undergone FETO.
KEYWORDS:
Congenital diaphragmatic hernia; Follow-up; Hernia recurrence; Survival PMID: 31089883 DOI: 10.1007/s00383-019-04484-3
