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

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Keita Terui1, Tomoaki Taguchi, Keiji Goishi

  • 1Department of Pediatric Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuou-ku, Chiba, 260-8677, Japan, kta@cc.rim.or.jp.

Pediatric Surgery International
|September 14, 2014
PubMed

Insights

Infants with congenital diaphragmatic hernia (CDH) have a higher risk of gastroesophageal reflux disease (GERD). A large diaphragmatic defect (>75%) significantly increases the need for antireflux surgery in these patients.

Area of Science:

  • Pediatric Surgery
  • Gastroenterology
  • Neonatology

Background:

  • Gastroesophageal reflux disease (GERD) is a common complication in infants with congenital diaphragmatic hernia (CDH).
  • Understanding risk factors for GERD in CDH patients is crucial for optimizing management and outcomes.

Purpose of the Study:

  • To identify risk factors associated with the development and progression of GERD in infants diagnosed with CDH.
  • To evaluate factors influencing the need for medical therapy and surgical intervention for GERD in this population.

Main Methods:

  • A retrospective observational study included infants with CDH operated between 2006 and 2010.
  • Primary outcomes included completion of medical therapy for GERD and incidence of GERD-related surgery.
  • Statistical analyses employed Kaplan-Meier survival analysis and Cox proportional hazards regression.

Main Results:

  • Of 182 CDH cases, 23.8% received medical therapy for GERD, with 60% completing treatment.
  • Prenatal CDH detection and tube feeding at discharge were linked to unsuccessful GERD medical therapy weaning.
  • A diaphragmatic defect exceeding 75% and lower gestational age were significant predictors for requiring antireflux surgery.

Conclusions:

  • A diaphragmatic defect greater than 75% is a significant risk factor for the future need of antireflux surgery in infants with CDH.
  • Gestational age also plays a role in predicting the necessity for surgical intervention for GERD in CDH patients.
Abstract

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