An Pediatr (Engl Ed)

. 2024 Jul 5:S2341-2879(24)00172-8.

 doi: 10.1016/j.anpede.2024.04.020. Online ahead of print. https://pubmed.ncbi.nlm.nih.gov/38971707/

Congenital diaphragmatic hernia: relationship between defect size and outcome. Experience in a reference centre

Jesica Cecilia Otaño ¹, Victoria Murua ¹, Julieta Rugilo ¹, Aixa Reusmann ², Camila Gonzalez Ruhrnschopf ², Diana Fariña ¹, Gisela Lujan Salas ³

Affiliations expand

• PMID: 38971707
• DOI: 10.1016/j.anpede.2024.04.020

Free article

Abstract

Introduction: Congenital diaphragmatic hernia (CDH) remains a therapeutic challenge. The surgical classification recommended by the Congenital Diaphragmatic Hernia study group (CDHSG), based on the size of the defect, is used for staging in reference centres. Larger defects are associated with poorer outcomes. Our aim was to describe and compare the morbidity at hospital discharge of newborns who underwent surgical correction of CDH at the Juan P. Garrahan, according to the surgical staging of the defect proposed by the CDHSG.

Material and methods: The study included patients with CDH admitted to the Juan P. Garrahan Hospital between 2012 and 2020, and we analysed the distribution, morbidity and mortality associated with the size of the defect. We carried out a descriptive analysis, calculating measures of central tendency and dispersion, and bivariate and multivariate analyses.

Results: A total of 230 patients with CDH were admitted and 158 underwent surgery. We found that defect sizes C and D sizes were associated with an increased risk of chronic pulmonary disease (CPD) (OR, 5.3; 95% CI, 2.2-13.4; P<.0000), need of extracorporeal membrane oxygenation (OR 3.9; 95% CI, 1.3-12.8; P<.005) and chylothorax (OR, 2.1; 95% CI, 0.8-6.4; P<.10]. The multivariate analysis revealed that a large defect size (C-D) was independently and significantly associated with CPD (OR 4.19; 95% CI, 1.76-9.95).

Conclusion: Staging the defect according to de CDHSG classification during surgery allows the application of uniform management criteria and the prediction of patient outcomes and complications during the hospital stay.

Keywords: Congenital diaphragmatic hernia; Defect size; Evolución; Hernia diafragmática congénita; Outcomes; Tamaño del defecto.

Copyright © 2024 Asociación Española de Pediatría. Published by Elsevier España, S.L.U. All rights reserved.