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Transuterine Fetal Tracheal Occlusion Model in Mice
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Large diaphragmatic defect: are skeletal deformities preventable?

P Kuklová1, D Zemková, M Kyncl

  • 1Department of Pediatric Surgery, 2nd Faculty of Medicine and University Hospital Motol, Charles University in Prague, V úvalu 84, 15000, Prague 5, Czech Republic.

Pediatric Surgery International
|September 21, 2011
PubMed
Summary

Children with congenital diaphragmatic hernia (CDH) show impaired growth and nutritional status. Chest wall deformities like pectus excavatum are common, with differences noted between Gore-Tex patch and primary repair methods.

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Area of Science:

  • Pediatric Surgery
  • Developmental Pediatrics
  • Thoracic Surgery

Background:

  • Congenital diaphragmatic hernia (CDH) is a complex condition affecting infant development.
  • Skeletal deformities and growth issues are potential long-term complications in CDH survivors.
  • Understanding the impact of surgical repair methods on outcomes is crucial.

Purpose of the Study:

  • To compare growth, nutritional status, and the incidence of chest wall deformities and scoliosis in CDH survivors.
  • To evaluate differences between large defects repaired with Gore-Tex patch versus smaller defects with primary reconstruction.

Main Methods:

  • An anthropometric study of 53 children post-CDH repair was conducted.
  • Measurements included weight, height, skin-fold thickness, BMI, and thoracic index (TI).

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  • Patients were grouped by repair type: Gore-Tex patch (10) vs. primary repair (43).

    • Main Results:

    • CDH survivors exhibited significantly lower height, weight, BMI, and TI SDS compared to population norms.
    • Pectus excavatum (47%) and poor posture (33%) were prevalent; scoliosis occurred in 5%.
    • The Gore-Tex group showed a higher incidence of pectus excavatum and lower BMI SDS compared to the primary repair group.

    Conclusions:

    • CDH impacts somatic development beyond lung growth, affecting anthropometric parameters and skeletal structure.
    • The type of diaphragmatic reconstruction may influence specific outcomes like BMI and pectus excavatum incidence.
    • Further research is needed to determine if observed changes relate to repair type or defect size.