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Congenital diaphragmatic eventration in children: 12 years' experience with 177 cases in a single institution
Shengde Wu1, Na Zang2, Jin Zhu3
1Ministry of Education Key Laboratory of Child Development and Disorders; Key Laboratory of Pediatrics in Chongqing, CSTC2009CA5002; Chongqing International Science and Technology Cooperation Center for Child Development and Disorders; Department of Pediatric Surgery, Children's Hospital of Chongqing Medical University, Chongqing, China.
Insights
Congenital diaphragmatic eventration (CDE) in children presents with varied symptoms. Diaphragmatic plication surgery effectively treated symptomatic CDE, leading to good outcomes with no recurrence observed in this study.
Area of Science:
- Pediatric Surgery
- Thoracic Surgery
- Congenital Abnormalities
Background:
- Congenital diaphragmatic eventration (CDE) is a rare condition affecting the diaphragm.
- Symptoms range from asymptomatic to severe respiratory distress.
Purpose of the Study:
- To summarize diagnostic and treatment aspects of CDE in children.
- To analyze complications, treatment, and long-term outcomes of diaphragmatic plication.
Main Methods:
- Retrospective analysis of medical records of 177 children treated for CDE (2000-2011).
- Data included demographics, symptoms, associated anomalies, surgical procedures, and follow-up details.
Main Results:
- 177 children (128 male, 49 female) diagnosed with CDE.
- 86 patients were symptomatic with respiratory issues; 91 were asymptomatic.
- Diaphragmatic plication was performed on 86 symptomatic patients with no recurrence.
Conclusions:
- CDE severity varies widely.
- Timely diagnosis and treatment of symptomatic CDE improve outcomes.
- Diaphragmatic plication is an effective surgical treatment for CDE with good long-term results.
Objective:
This study sought to summarize the diagnostic and treatment aspects of congenital diaphragmatic eventration (CDE) in children by retrospectively analyzing their medical records to identify and understand the complications of CDE, its treatment, and to evaluate the long-term outcomes of diaphragmatic plication.
Methods:
The medical records of children who received treatment for CDE from January 2000 to December 2011 at the Children's Hospital of Chongqing Medical University, China were analyzed. Data analyzed included the following: age, sex, symptom, location of eventration, associated anomalies, surgical procedures, complications, and survival and follow up details after diaphragmatic plication.
Results:
The medical records of 177 children (boys: 128, girls: 49, mean age: 10.28±2.35 months) with CDE were included in this study. Specific symptoms of eventration of the diaphragm were reported for 86 cases; and the typical symptoms included rapid breathing, vomiting, and recurrent respiratory infections. Except for a bilateral case, all the other patients had unilateral CDE. Associated malformations were observed in 31 cases (17.5%), hypoplastic lung (10 cases) was the most common followed by congenital heart disease (9 cases), and cryptorchidism (3 cases). Interestingly, 91 patients were asymptomatic. Diaphragmatic plication was performed in all symptomatic patients (86 cases, 48.5%) and none had recurrence.
Conclusions:
Clinical symptoms of CDE varied in severity, ranging from asymptomatic conditions to life-threatening respiratory distress. Timely accurate diagnosis and treatment of symptomatic CDE could effectively resolve respiratory morbidity and reduce complications. The diaphragm plication surgery provided good results among the study population with no recurrence.