Analysis of risk factors of long-term complications in congenital diaphragmatic hernia: A single institution's experience

Takayasu, Hajime; Masumoto, Kouji; Jimbo, Takahiro; Sakamoto, Naoya; Sasaki, Takato; Uesugi, Takehiko; Gotoh, Chikashi; Urita, Yasuhisa; Shinkai, Toko

doi:10.1016/j.asjsur.2015.02.005

Cited by 13 publications

(9 citation statements)

References 19 publications

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“…Her pregnancy and positive COVID-19 status were considered a significant trigger for the lower digestive tract bleeding. diagnosed with congenital diaphragmatic hernia and mesh repair at birth were analyzed, reporting the following complications in order of frequency: intestinal obstruction (23%), gastroesophageal reflux (9.5%), and thoracic wall deformities (2%); no cases of intestinal perforation were reported due to mesh migration, as in the case of our patient [3]. Li et al conducted a systematic review in 2019 that analyzed mesh migration in patients with hiatal hernia and subsequent intestinal erosion.…”

Section: Discussionmentioning

confidence: 89%

“…Fetal complications include preterm delivery. A congenital diaphragmatic hernia is a developmental defect of the posterolateral diaphragm [3]. We hereby report the case of a pregnant patient, with a history of a Bochdalek hernia repaired at birth, SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) infection, and gastrointestinal bleeding.…”

Section: Introductionmentioning

confidence: 99%

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Gastrointestinal Bleeding associated with Bowel Perforation by Foreign body in the Context of a SARS-CoV-2 Infection during Pregnancy

Jiménez-Chaidez¹,

Gómez-Sousa²,

Ruiz-Beltrán³

et al. 2021

JCR

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Section: Discussionmentioning

confidence: 89%

Section: Introductionmentioning

confidence: 99%

Gastrointestinal Bleeding associated with Bowel Perforation by Foreign body in the Context of a SARS-CoV-2 Infection during Pregnancy

Jiménez-Chaidez¹,

Gómez-Sousa²,

Ruiz-Beltrán³

et al. 2021

JCR

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“…Surgical morbidity tends to relate to the defect size, need for patch repair, and liver herniation. 31,32…”

Section: Intra-operative Complicationsmentioning

confidence: 99%

“…A significant number of CDH patients may live with complications (respiratory, nutritional, musculoskeletal, neurological, and gastrointestinal morbidities), resulting in poor quality of life. 4,32,71 Long-term morbidity is mostly associated with perioperative complications, defect size, need for patch repair, liver-up, and the existence of major morbidities at discharge. 32 Chronic respiratory disease is common in CDH patients, in some cases requiring oxygen at home for long periods of time.…”

Section: Long-term Morbiditymentioning

confidence: 99%

“…4,32,71 Long-term morbidity is mostly associated with perioperative complications, defect size, need for patch repair, liver-up, and the existence of major morbidities at discharge. 32 Chronic respiratory disease is common in CDH patients, in some cases requiring oxygen at home for long periods of time. Diaphragmatic rigidity and thoracic deformities might play a minor role in chronic lung disease.…”

Section: Long-term Morbiditymentioning

confidence: 99%

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Perioperative Complications of Congenital Diaphragmatic Hernia Repair

Barroso

Correia‐Pinto

2018

Eur J Pediatr Surg

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Although improvements have been made, the management of congenital diaphragmatic hernia (CDH) remains a major challenge for perinatologists and neonatal surgeons. Many aspects of the disease remain unknown and, being a rare entity, evidence-based data are hard to find. Surgical morbidity is considerable and affects long-term quality of life. Perioperative complications have been reviewed focusing on thoracoscopic repair. Intraoperative acidosis was more severe during thoracoscopy when compared with open surgery (OS), though it is possible that later neurodevelopment was not affected. Even so, strategies have been outlined to reduce acidosis, such as decreasing carbon dioxide (CO) insufflation after reduction of the herniated viscera into the abdomen is complete. The risk of pleural complications decreased after introduction of gentle ventilation techniques and minimally invasive surgery (MIS); thus, the use of a prophylactic intraoperative thoracic tube is not routinely required. Recurrence rate was higher in large CDH and following MIS repair. Technical demands play an important role, therefore, in avoiding complications; every step of the OS technique must be strictly accomplished. In large defects, the use of prosthetic patch might reduce recurrence rate, even by MIS repair, once again only if technical demands are overcome with meticulous rules of suturing. Thoracoscopy significantly reduced the incidence of bowel obstruction and recovery time and improved cosmesis. The best approach of CDH is yet to be found, and it goes far beyond the management of perioperative complications. Meanwhile randomized controlled studies, namely on the outcome of thoracoscopic repair, are required to inform further practice.

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Neurodevelopmental outcomes in children with isolated congenital diaphragmatic hernia: A systematic review and meta‐analysis

et al. 2021

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Background: Congenital diaphragmatic hernia (CDH) reportedly has neurologic consequences in childhood however little is known about the impact in isolated CDH.Aims: Herein we aimed to describe the risk of neurodevelopmental complications in children born with isolated CDH. Materials & Methods:We systematically reviewed literature for reports on the neurological outcome of infants born with isolated CDH. The primary outcome was neurodevelopmental delay. Secondary outcomes included, motor skills, intelligence, vision, hearing, language and behavior abnormalities.Results: Thirteen out of 87 (15%) studies reported on isolated CDH, including 2624 out of 24,146 children. Neurodevelopmental delay was investigated in four studies and found to be present in 16% (3-34%) of children. This was mainly attributed to motor problems in 13% (2-30%), whereas cognitive dysfunction only in 5% (0-20%) and hearing in 3% (1-7%). One study assessed the effect of fetal surgery. When both isolated and non-isolated children were included, these numbers were higher. Discussion: This systematic review demonstrates that only a minority of studies focused on isolated CDH, with neurodevelopmental delay present in 16% of children born with CDH. Conclusion:To accurately counsel patients, more research should focus on isolated CDH cases and examine children that underwent fetal surgery. Lennart Van der Veeken and Simen Vergote shared first authorship. #Jan Deprest and Matteo Bruschettini shared last authorship.This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

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Analysis of risk factors of long-term complications in congenital diaphragmatic hernia: A single institution's experience

Abstract: Patients who developed short-term complications seemed to be at risk of long-term complications. Therefore, to minimize long-term morbidities in CDH survivors, the prevention of short-term complications might be important.

Cited by 13 publications

References 19 publications

Gastrointestinal Bleeding associated with Bowel Perforation by Foreign body in the Context of a SARS-CoV-2 Infection during Pregnancy

Gastrointestinal Bleeding associated with Bowel Perforation by Foreign body in the Context of a SARS-CoV-2 Infection during Pregnancy

Perioperative Complications of Congenital Diaphragmatic Hernia Repair

Neurodevelopmental outcomes in children with isolated congenital diaphragmatic hernia: A systematic review and meta‐analysis

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