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Research: Clinical characteristics and outcomes of the right congenital diaphragmatic hernia compared to the left: a 10-year single-center experience

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Research: Clinical characteristics and outcomes of the right congenital diaphragmatic hernia compared to the left: a 10-year single-center experience

Pediatr Surg Int

Pediatr Surg Int

. 2021 Aug 26. doi: 10.1007/s00383-021-04999-8. Online ahead of print. https://pubmed.ncbi.nlm.nih.gov/34436672/

Clinical characteristics and outcomes of the right congenital diaphragmatic hernia compared to the left: a 10-year single-center experience

Masamune Okamoto 1Hizuru Amano 1Hiroo Uchida 2Akinari Hinoki 1Takahisa Tainaka 1Chiyoe Shirota 1Wataru Sumida 1Kazuki Yokota 1Satoshi Makita 1Aitaro Takimoto 1Akihiro Yasui 1Yoichi Nakagawa 1Affiliations expand

Abstract

Purpose: The features of right-sided congenital diaphragmatic hernias (RCDHs) are quite different from those of left-sided CDHs (LCDHs). We have summarized the features of RCDHs experienced in our institution.

Methods: This retrospective study analyzed the cases of patients with CDH registered at our institution between 2011 and 2020. Defects on each side were compared based on prenatal diagnosis, medical treatment, type of surgery, and outcomes.

Results: A total of 101 patients underwent surgery at our institution during the neonatal period, and 11 had RCDHs. RCDHs and LCDHs were significantly different in terms of extracorporeal membrane oxygenation (36% vs. 6%, p = 0.002), patch repair (81% vs. 28%, p < 0.001), recurrence rate (36% vs. 11%, p = 0.022), and length of hospital stay (117 days vs. 51 days, p = 0.012). The severity of the fetal diagnosis did not reflect postnatal severity. All patients with RCDH survived to discharge, and there was no significant difference in survival rate between the right and left sides.

Conclusion: Neonates with RCDH required more intensive treatments; however, the survival rate was comparable between RCDH and LCDH. RCDH was significantly different from LCDH and an optimal treatment strategy for RCDHs should be established.

Keywords: Congenital diaphragmatic hernia; Neonate; Prenatal diagnosis; Right congenital diaphragmatic hernia.

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