Predictors of gastroesophageal reflux in neonates with congenital diaphragmatic hernia

Prognostic factors of gastroesophageal reflux disease in congenital diaphragmatic hernia: a multicenter study

“…Institutional bias might be one of the possible interpretation that long gestational age is linked the necessity of antireflux surgery, because antireflux surgery was performed more frequently in the institutions which had higher rate of patients of gestational age of [265 day. Large diaphragmatic defect seems to be the reasonable and specific risk factor of future need for surgery, and consistent with the previous reports [7,8]. And, it is basically consistent with the result that prenatal diagnosis is linked the duration of medical therapy for GERD, because patients with prenatal diagnosis tended to have large diaphragmatic defect.…”

“…Historically, the risk of GERD in CDH is thought to have increased with improvement of the survival of severe CDH [4,5]. Need for patch is one of risk factors of severe GERD which needs interventions [6][7][8][9], however, some have reported negative [10] or converse data [11] in pathological GERD. Indicators of severity of CDH, such as liver herniation [7], thoracic position of the stomach [9,10], and time of diagnosis [10] were another risk factors reported to date.…”

The long-term follow-up of patients with a congenital diaphragmatic hernia: a broad spectrum of morbidity

“…According to most studies, the incidence of GERD in the first years after repair ranges between 20 and 72% [33,93,96,[98][99][100]. Even higher incidences have been reported [32].…”

“…Yet, GERD appears to some extent to be related to size of the diaphragmatic defect, because it was more frequent and more severe in children requiring a prosthetic patch [100,107] or ECMO [28,32,33]. On the other hand, use of a prosthetic patch could possibly diminish morbidity related to GERD by lowering the strain on the left crus [96,106].…”

Congenital Diaphragmatic Hernia Survivors: Outcomes in Infancy, Childhood and Adolescence

“…The clinical presentation varies: some infants and children will experience recurrent vomiting, while in others GER may manifest as persistent bradycardic spells or aspiration pneumonia (Kieffer et al, 1995). Although many CDH survivors can be successfully managed with medical treatment, a significant number -up to 23% in one series -have severe GER requiring surgical intervention with fundoplication (Su et al, 2007). Factors associated with need for fundoplication are patch repair, ECMO treatment, and intrathoracic liver position (Diamond et al, 2007;Su et al, 2007).…”