One-year outcomes of congenital diaphragmatic hernia repair: Factors associated with recurrence and complications

Cioci, Alessia C.; Urréchaga, Eva M.; Parreco, Joshua; Remer, Lindsay F.; Cowan, Maiya; Pérez, Eduardo A.; Sola, Juan E.; Thorson, Chad M.

doi:10.1016/j.jpedsurg.2020.09.018

Cited by 17 publications

(13 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…At the same time, thoracoscopic repair (TR) of CDH is reported to have a greater risk of recurrence (2–9%) than the classic repair through laparotomy (1–4%) ( 2 ). Cioci et al also observed a significantly higher recurrence in those patients who underwent MIS repair (48%) as compared to open repair (OR) (16%) ( 23 ). However, significance was not reached in other series ( 30 ), and some recent studies have identified a similar risk of recurrence between TR and OR in selected patients ( 39 – 45 ).…”

Section: Predisposing Factorsmentioning

confidence: 97%

“…Nevertheless, other factors could be involved in the higher recurrence risk in MIS. Therefore, it has been suggested to limit MIS to the smallest defects, classified as A or B, by the Congenital Diaphragmatic Hernia Study Group (CDHSG) Staging System ( 23 ). Additional proposed selection criteria are cardiovascular stability and no pulmonary hypertension, mild symptoms or asymptomatic, liver down, late presentation or postnatal diagnosis, and absence of severe comorbidities ( 31 , 46 ).…”

Section: Predisposing Factorsmentioning

confidence: 99%

“…Cioci et al demonstrated as low-volume CDH centers have significantly higher recurrence rates and hospital costs than high-volume CDH hospitals. Therefore, the de-centralization of CDH patients would be a further PF ( 23 ). Consequently, through a hub and spoke model, the centralization of CDH delivery is needed to improve care and reduce costs, complications, morbidity, and mortality ( 50 ).…”

Section: Predisposing Factorsmentioning

confidence: 99%

“…However, a recent survey shows that recurrence is repaired with the same technique (laparotomy, thoracotomy, MIS) as the primary operation in 48% of cases ( 23 ). In the open approach, laparotomy is always favored over thoracotomy.…”

Section: Managementmentioning

confidence: 99%

“…Ultimately, the centralization of CDH patients to referral high-volume centers is pivotal to manage possible complications with an appropriate and customized follow-up plan ( 23 ).…”

Section: Conclusion and Future Perspectivesmentioning

confidence: 99%

See 4 more Smart Citations

Recurrence of Congenital Diaphragmatic Hernia: Risk Factors, Management, and Future Perspectives

et al. 2022

View full text Add to dashboard Cite

Recurrence is one of the most common surgical complications in Congenital Diaphragmatic Hernia (CDH). It could remain clinically silent for a long time or present as an acute complication week, months, or even years after the primary surgery. Several risk factors have been identified so far. An extended diaphragmatic defect represents one of the leading independent risk factors, together with indirect signs of large defect such as the liver position related to the diaphragm and the use of the prosthetic patch and with the use of a minimally invasive surgical (MIS) approach. However, the exact contribution of each factor and the overall risk of recurrence during the life span still need to be fully understood. This mini-review aims to give an overview of the current knowledge regarding CDH recurrence, focusing on predisposing factors, clinical presentation, management and follow-up of high-risk patients, and future perspectives.

show abstract

Section: Predisposing Factorsmentioning

confidence: 97%

Section: Predisposing Factorsmentioning

confidence: 99%

Section: Predisposing Factorsmentioning

confidence: 99%

Section: Managementmentioning

confidence: 99%

“…Ultimately, the centralization of CDH patients to referral high-volume centers is pivotal to manage possible complications with an appropriate and customized follow-up plan ( 23 ).…”

Section: Conclusion and Future Perspectivesmentioning

confidence: 99%

See 3 more Smart Citations

Recurrence of Congenital Diaphragmatic Hernia: Risk Factors, Management, and Future Perspectives

et al. 2022

View full text Add to dashboard Cite

show abstract

Impact of the COVID-19 pandemic on congenital diaphragmatic hernia patients: a single-center retrospective study

et al. 2022

View full text Add to dashboard Cite

Purpose To investigate the impact of COVID-19 on the treatment of children with congenital diaphragmatic hernia (CDH). Methods We retrospectively collected and compared the data of patients with CDH admitted between January 1, 2020 and December 31, 2021(study group) with the CDH patients admitted before the pandemic between January 1, 2018 and December 31, 2019 (control group). Results During the pandemic, 41 patients with CDH diagnosed prenatally were transferred to our hospital, and 40 underwent surgical repair. The number of patients treated in our hospital increased by 24.2% compared with the 33 patients before the pandemic. During the pandemic, the overall survival rate, postoperative survival rate and recurrence rate were 85.4%, 87.5% and 7.3%, respectively, and there were no significant differences compared with the control group (75.8%, 83.3% and 9.1%, respectively). The average length of hospital stay in patients admitted during the pandemic was longer than that in the control group (31 days vs. 16 days, P < 0.001), and the incidence of nosocomial infection was higher than that in the control group (19.5% vs. 3%, P = 0.037). Conclusions CDH patients confirmed to be SARS-CoV-2 infection-free can receive routine treatment. Our data indicate that the implementation of protective measures during the COVID-19 pandemic, along with appropriate screening and case evaluation, do not have a negative impact on the prognosis of children.

show abstract

A predictive scoring system for small diaphragmatic defects in infants with congenital diaphragmatic hernia

et al. 2022

View full text Add to dashboard Cite

Purpose: To develop a predictive score for small diaphragmatic defects in infants with congenital diaphragmatic hernia (CDH).Methods: The Japanese CDH Study Group cohort was randomly divided into derivation (n = 397) and validation (n = 396) datasets. Using logistic regression, a prediction model and weighted scoring system for small diaphragmatic defects were created from derivation dataset and validated with validation dataset.Results: Six weighted variables were selected: no hydramnios, 1 point; 1-minute Apgar score of 5-10, 1 point; apex type of the lung (left lung is detected radiographically in apex area), 1 point; oxygenation index < 8, 1 point; abdominal nasogastric tube (tip of the nasogastric tube is detected radiographically in abdominal area), 2 points; no right-to-left ow of ductus arteriosus, 1 point. In validation dataset, rates of small diaphragmatic defects for Possible (0-3 points), Probable (4-5 points), and De nite (6-7 points) groups were 36%, 81%, and 94%, respectively (p < 0.001). Additionally, sensitivity, speci city, positive predictive value, and C statistics were 0.78, 0.79, 0.88, 0.76, and 0.45, 0.94, 0.94, 0.70 for Probable and De nite groups, respectively. Conclusion: Our simple scoring system effectively predicted small diaphragmatic defects in infants with CDH and is useful to determine thoracoscopic surgery indication.

show abstract

One-year outcomes of congenital diaphragmatic hernia repair: Factors associated with recurrence and complications

Cited by 17 publications

References 29 publications

Recurrence of Congenital Diaphragmatic Hernia: Risk Factors, Management, and Future Perspectives

Recurrence of Congenital Diaphragmatic Hernia: Risk Factors, Management, and Future Perspectives

Impact of the COVID-19 pandemic on congenital diaphragmatic hernia patients: a single-center retrospective study

A predictive scoring system for small diaphragmatic defects in infants with congenital diaphragmatic hernia

Contact Info

Product

Resources

About