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Long-term outcomes of congenital diaphragmatic hernia: A single institution experience
Claire D Gerall1, Latoya A Stewart1, Jessica Price1
1Division of Pediatric Surgery, Department of Surgery. Columbia University Vagelos College of Physicians and Surgeons / NewYork-Presbyterian Morgan Stanley Children's Hospital, 3959 Broadway CH2N, New York, NY 10032, USA.
Insights
Survival rates for congenital diaphragmatic hernia (CDH) are rising, leading to more long-term health issues. This study reviews CDH repair outcomes and highlights the need for standardized, multidisciplinary follow-up care to optimize patient health.
Area of Science:
- Pediatric Surgery
- Neonatal Care
- Long-term Health Outcomes
Background:
- Increasing survival rates for congenital diaphragmatic hernia (CDH) necessitate a focus on long-term patient sequelae.
- The management of CDH requires comprehensive understanding of its chronic complications.
Purpose of the Study:
- To present the outcomes of patients who underwent CDH repair.
- To discuss the standardization of follow-up care in a multidisciplinary clinic for CDH patients.
Main Methods:
- Retrospective review of 193 patients who underwent CDH repair.
- Data collected from a multidisciplinary follow-up clinic between January 1, 2005, and December 1, 2020.
Main Results:
- Common long-term outcomes include gastroesophageal reflux disease (42.0%), neurodevelopmental delay (28.6%), and asthma (23.6%).
- Diaphragmatic hernia recurrence occurred in 10.9% of patients.
- Other sequelae include chest wall deformity (15.5%), scoliosis (11.4%), and ADHD (7.3%).
Conclusions:
- Improved survival in CDH mandates continuous study and refinement of long-term care strategies.
- Standardized, multidisciplinary follow-up is crucial for optimizing the long-term health of CDH survivors.
Background/Purpose:
As survival rates for patients with congenital diaphragmatic hernia (CDH) increase, long-term sequelae become increasingly prevalent. We present the outcomes of patients who underwent CDH repair at our institution and discuss standardization of follow-up care in our long-term multidisciplinary follow-up clinic.
Methods:
A retrospective review of patients followed in multidisciplinary clinic after CDH repair at our institution from January 1, 2005 to December 1, 2020.
Results:
A total of 193 patients met inclusion criteria, 73 females (37.8%) and 120 males (62.2%). Left-sided defects were most common (75.7%), followed by right-sided defects (20.7%). Median age at repair was 4 days (IQR 3-6) and 59.6% of all defects required patch repair. Median length of stay was 29 days (IQR 16.8-50.0). Median length of follow up was 49 months (IQR 17.8-95.3) with 25 patients followed for more than 12 years. Long-term outcomes included gastroesophageal reflux disease (42.0%), diaphragmatic hernia recurrence (10.9%), asthma (23.6%), neurodevelopmental delay (28.6%), attention deficit hyperactivity disorder (7.3%), autism (1.6%), chest wall deformity (15.5%), scoliosis (11.4%), and inguinal hernia (6.7%).
Conclusion:
As survival of patients with CDH improves, long-term care must be continuously studied and fine-tuned to ensure appropriate surveillance and optimization of long-term outcomes.
