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Long-Term Outcomes of Congenital Diaphragmatic Hernia: Report of a Multicenter Study in Japan
Masaya Yamoto1, Kouji Nagata2, Keita Terui3
1Department of Pediatric Surgery, Shizuoka Children's Hospital, Shizuoka 420-8660, Japan.
Insights
Improved congenital diaphragmatic hernia (CDH) survival necessitates long-term outcome research. This study tracked CDH survivors, revealing age-related complication trends for optimized lifelong care.
Area of Science:
- Pediatric Surgery
- Neonatal Care
- Long-term Health Outcomes
Background:
- Congenital diaphragmatic hernia (CDH) survival rates have improved due to advancements in treatment.
- Long-term outcomes for CDH survivors remain a challenge, hindering the establishment of optimal care pathways into adolescence and adulthood.
- The Japanese CDH Study Group (JCDHSG) database was utilized to evaluate long-term outcomes in CDH patients.
Purpose of the Study:
- To evaluate the long-term outcomes of patients with congenital diaphragmatic hernia (CDH).
- To identify trends in complications and healthcare needs among CDH survivors.
- To inform the development of optimized surveillance and follow-up strategies for CDH patients.
Main Methods:
- Data from 747 patients born with CDH between 2006 and 2018 were analyzed.
- Participants were enrolled and followed at ages 1.5, 3, 6, and 12 years.
- Follow-up included assessment of long-term complications, subsequent operations, and home medical care requirements.
Main Results:
- The study included 747 patients, with a survival rate of 83.8%.
- Complication rates varied with age, with 45.4% at 1.5 years and 43.6% at 12 years.
- Specific complications like recurrence and pneumonia decreased with age, while thoracic deformity increased; home care needs also decreased over time.
Conclusions:
- Improving survival rates for congenital diaphragmatic hernia (CDH) underscore the need for ongoing research.
- Fine-tuning long-term care strategies is crucial for optimizing surveillance and follow-up of CDH survivors.
- Understanding age-related complication patterns is essential for comprehensive lifelong management of CDH.
Background:
Treatment modalities for neonates with congenital diaphragmatic hernia (CDH) have greatly improved in recent years, with a concomitant increase in survival. However, long-term outcomes restrict the identification of optimal care pathways for CDH survivors in adolescence and adulthood. Therefore, we evaluated the long-term outcomes within the Japanese CDH Study Group (JCDHSG).
Methods:
Participants were born with CDH between 2006 and 2018 according to the JCDHSG. Participants were enrolled in the database at 1.5, 3, 6, and 12 years old. Follow-up items included long-term complications, operations for long-term complication, and home medical care.
Results:
A total of 747 patients were included in this study, with 626 survivors (83.8%) and 121 non-survivors (16.2%). At 1.5, 3, 6, and 12 years old, 45.4%, 36.5%, 34.8%, and 43.6% developed complications, and 20.1%, 14.7%, 11.5%, and 5.1% of participants required home care, respectively. Recurrence, pneumonia, pneumothorax, gastroesophageal reflux disease, and intestinal obstruction decreased with age, and thoracic deformity increased with age.
Conclusions:
As CDH survival rates improve, there is a need for continued research and fine-tuning of long-term care to optimize appropriate surveillance and long-term follow-up.
