Right- versus left-sided congenital diaphragmatic hernia

Abstract

In congenital diaphragmatic hernia, the location of the defect has a substantial impact on postnatal survival and the development of chronic lung disease. In left-sided congenital diaphragmatic hernia, pulmonary hypertension resistant to therapeutic management, including extracorporeal membrane oxygenation, is more common and is associated with a higher rate of neonatal demise. Right-sided congenital diaphragmatic hernia infants have an increased benefit from extracorporeal membrane oxygenation but the better survival entails a higher rate of chronic lung disease.

Outcomes of Congenital Diaphragmatic Hernia in the Modern Era of Management

“…Though the patients in our study with a right sided CDH did have a greater need for ECMO, they did not have either worse PH, measured at 1 or 3 months of age, or decreased survival when compared to left sided CDH. It is difficult to definitively determine the etiology of these findings, but our findings and those of Schaible (18) may be reason enough for practitioners seeing these patients during prenatal counseling to be cautious in predicting a dismal prognosis for right sided CDH.…”

Right‐sided congenital diaphragmatic hernia in a decade of fetal surgery

“…Right‐sided CDH (RCDH) might not just be a variant of LCDH, but rather a separate entity with different outcomes and treatment response; potentially with the need for its own prenatal prediction model . This is difficult to determine with certainty, because of the rarity of RCDH as well as the uncertainty of how one can correct for severity of hypoplasia—given that prenatal predictors for RCDH remain poorly validated .…”

Avaliação morfológica e funcional da musculatura cardíaca de neonatos de coelhos com hérnia diafragmática congênita criada cirurgicamente

“…Congenital diaphragmatic hernia (CDH) is the congenital malformation of the diaphragma that allows herniation of abdominal contents into the thorax, resulting in lung and heart compression [1][2][3] . The incidence of CDH is 1 in 3000 live births, and the mortality rate is between 30-50% [4][5][6] .…”

“…Right-sided congenital diaphragmatic hernia (RCDH) is still a challenge to pediatric surgery, while the left-sided CDH (LCDH) is largely studied and presents most management and treatment globally standardized, the RCDH has many contentious questions yet. Multiples comparison studies between LCDH and RCDH are controversial about the severity degree and survival rate in this malformation (1,2). The prevalence of CDH is about 1-4 per 10.000 births (3), RCDH represents approximately 20% of all CDHs, and it is defined by the postero-lateral malformation of the diaphragm in the right side, leading to liver and bowel intrathoracic herniation, while the LCDH is the malformation of the diaphragm in the left side (80%), allowing bowel, stomach and, when severe, liver intrathoracic herniation.…”

“…diafragma é um músculo situado na caixa torácica que reveste a abertura inferior do tórax e compartimentaliza o tronco nas regiões torácica e abdominal1 . A hérnia diafragmática congênita (CDH), descrita por Bochladek em 1848, ocorre em 80% dos pacientes na região póstero-lateral esquerda, e é um defeito do desenvolvimento que resulta no não fechamento do diafragma e possibilita a protrusão das vísceras abdominais para o interior da caixa torácica 2, 3 .…”