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Congenital diaphragmatic hernia: the good, the bad, and the tough

Emrah Aydin1, Foong-Yen Lim2, Paul Kingma3

  • 1Division of Pediatric General and Thoracic Surgery, The Center for Fetal Cellular and Molecular Therapy, Cincinnati Fetal Center, 3333 Burnet Avenue, MLC 11025, Cincinnati, OH, 45229-3039, USA. dremrahaydin@yahoo.com.

Pediatric Surgery International
|January 26, 2019
PubMed

Insights

Congenital diaphragmatic hernia (CDH) patients with a hernia sac had better outcomes, while those with liver herniation faced worse prognoses. Accompanying syndromes had minimal impact on CDH survival rates.

Area of Science:

  • Pediatric Surgery
  • Neonatal Care
  • Congenital Anomalies

Background:

  • Congenital diaphragmatic hernia (CDH) is a severe condition requiring specialized care.
  • Understanding prognostic factors is crucial for improving outcomes in CDH patients.

Purpose of the Study:

  • To identify factors associated with improved outcomes in patients diagnosed with congenital diaphragmatic hernia (CDH).

Main Methods:

  • Retrospective review of CDH patients admitted between 2003 and 2016 at a single institution with a fetal care center.
  • Inclusion criteria: CDH diagnosis and at least one-year follow-up.
  • Analysis of patient data to identify predictors of survival.

Main Results:

  • Overall survival to discharge was 73.1%, and survival to date was 69.5%.
  • Presence of a hernia sac (OR 7.158) was linked to better survival.
  • Liver herniation (OR 3.932) and accompanying syndromes (OR 2.795) were independent predictors of worse outcomes.

Conclusions:

  • The presence of a hernia sac in CDH patients is associated with better outcomes.
  • Thoracic herniation of the liver in CDH patients correlates with worse outcomes.
  • Accompanying syndromes, while challenging, showed a limited effect on the overall disease outcome.
Abstract

Keywords:
Cardiac anomaliesCongenital diaphragmatic herniaHernia sacLiver herniationPrognostic factorsSyndrome

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