Congenital diaphragmatic hernia: prenatal diagnosis permits immediate intensive care with high survival rate in isolated cases. A population-based study

2004 ◽  
Vol 24 (7) ◽  
pp. 487-493 ◽  
Author(s):  
Pierre Bétrémieux ◽  
Théophile Gaillot ◽  
Armelle de la Pintière ◽  
Alain Beuchée ◽  
Laurent Pasquier ◽  
...  
Keyword(s):  
Intensive Care ◽  
Prenatal Diagnosis ◽  
Survival Rate ◽  
Congenital Diaphragmatic Hernia ◽  
Diaphragmatic Hernia ◽  
Population Based ◽  
High Survival ◽  
High Survival Rate ◽  
Population Based Study

Outcome at 2 years of infants with congenital diaphragmatic hernia: a population-based study

2003 ◽  
Vol 75 (1) ◽  
pp. 250-256 ◽  
Author(s):  
Sophie M Jaillard ◽  
Véronique Pierrat ◽  
Angélina Dubois ◽  
Patrick Truffert ◽  
Pierre Lequien ◽  
...  
Keyword(s):  
Congenital Diaphragmatic Hernia ◽  
Diaphragmatic Hernia ◽  
Population Based ◽  
Population Based Study

A Population-Based Study of Congenital Diaphragmatic Hernia in Utah: 1988-1994

1996 ◽  
Vol 87 (6) ◽  
pp. 959-963 ◽  
Author(s):  
C CANNON ◽  
G DILDY ◽  
R WARD ◽  
M VARNER ◽  
D DUDLEY
Keyword(s):  
Congenital Diaphragmatic Hernia ◽  
Diaphragmatic Hernia ◽  
Population Based ◽  
Population Based Study

scholarly journals PRENATAL DIAGNOSIS AND SURGICAL INNOVATIONS IN CONGENITAL DIAPHRAGMATIC HERNIA: EVALUATION OF PRE- AND POST-OPERATIVE MANAGEMENT

2014 ◽  
Vol 6 (1) ◽  
Author(s):  
R. Angotti ◽  
F. Molinaro ◽  
K. Bici ◽  
E. Cerchia ◽  
M. Sica ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Prenatal Diagnosis ◽  
Minimally Invasive ◽  
Congenital Diaphragmatic Hernia ◽  
Diaphragmatic Hernia ◽  
Young Patients ◽  
Surgical Techniques ◽  
Female Ratio ◽  
Access Surgery

Introduction. Congenital diaphragmatic hernia (CDH) is still today considered a challenge from surgeons. Considerable progress in prenatal diagnosis, intensive care unit of neonates and surgical techniques, with the possibility to perform minimally access surgery, widely increased survival rates. The aim of this study is to analyze our series about long and short-term outcomes, also considering the progress made by minimally invasive techniques. Methods. The study was performed at Pediatric Surgery of Siena. It is a retrospective study that analyzed all patients with CDH (Bochdalek) treated in the last 14 years, from 2000 to 2013. Sex, side of the defect, presence of prenatal diagnosis, age of onset and symptoms, associate malformation, herniated organs, surgical technique and site of surgery, complications, recurrences, survival and followup were analyzed. Results. We included 23 patients. Five of them, were ruled out because of affected by diaphragmatic eventration or acquired diaphragmatic hernia. Forteen patients (77%) presented left CDH and 4 patients (23%) a right one. The male female ratio were 14:4. Prenatal diagnosis was performed in 5 patients (27,5%) at a mean gestational age of 29 weeks. Forteen patients (77%) had an early onset of symptoms (first day of life). Most common symptoms were respiratory distress and cyanosis; 4 patients (23%) had a late onset of symptoms, at a mean age of 9 months, and most common symptoms were failure to thrive and vomiting. Seven patients (39%) had associated malformation: common mesenterium (5 pts-71%). The colon was the most commonly herniated organ, present in 15 patients (83%), followed by small intestine in 13 patients (72%), stomach in 11 patients (61%), spleen in 9 patients (50%) and liver in 4 patients (23%). Seventeen patients (94,5%) underwent open surgery: 10 of them (59%) underwent a subcostal laparotomy approach, 7 of them (41%) underwent a supraumbelical laparotomy approach; 1 patient (5%) underwent minimally access surgery with thoracoscopy access. We performed performed surgery in the intensive care unit in 3 patients (16,5%). Six patients (33%) developed minor postoperatory complications. No patient had recurrence. Four patients died so we report a mortality rate of 23%. A follow-up investigation, with an average duration of 87 months, it is still going on in 5 patients (27,5%). Conclusions. The our survival rate was 77% and it reflects the encouraging reported data in the recent literature. These results are due to the reliability of the new resuscitation strategies, such as high-frequency oscillatory ventilation and the use of NO, the ability to perform surgery in the neonatal intensive care unit and, especially, to successfully perform minimally invasive surgery in newborn. The improvement of the survival showed the increasing of long-term morbidity end the requirement of a multidisciplinary followup. For these reasons, a multidisciplinary pathway for the management of young patients has been created, to follow them in a standardized way as early as the prenatal diagnosis.

A population-based study of congenital diaphragmatic hernia

Teratology ◽  
1992 ◽  
Vol 46 (6) ◽  
pp. 555-565 ◽  
Author(s):  
Claudine P. Torfs ◽  
Cynthia J. R. Curry ◽  
Thomas F. Bateson ◽  
Louis H. Honoré
Keyword(s):  
Congenital Diaphragmatic Hernia ◽  
Diaphragmatic Hernia ◽  
Population Based ◽  
Population Based Study

scholarly journals Is the Time Necessary to Obtain Preoperative Stabilization a Predictive Index of Outcome in Neonatal Congenital Diaphragmatic Hernia?

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Andrea Gentili ◽  
Rosina De Rose ◽  
Elisa Iannella ◽  
Maria Letizia Bacchi Reggiani ◽  
Mario Lima ◽  
...  
Keyword(s):  
Intensive Care ◽  
Survival Rate ◽  
Tracheal Intubation ◽  
Congenital Diaphragmatic Hernia ◽  
Diaphragmatic Hernia ◽  
Postoperative Period ◽  
Clinical Pathway ◽  
Clinical Condition ◽  
Predictive Index ◽  
Care Path

Background. The study aims to verify if the time of preoperative stabilization (≤24 or >24 hours) could be predictive for the severity of clinical condition among patients affected by congenital diaphragmatic hernia.Methods. 55 of the 73 patients enrolled in the study achieved presurgical stabilization and underwent surgical correction. Respiratory and hemodynamic indexes, postnatal scores, the need for advanced respiratory support, the length of HFOV, tracheal intubation, PICU, and hospital stay were compared between patients reaching stabilization in ≤24 or >24 hours.Results. Both groups had a 100% survival rate. Neonates stabilized in ≤24 hours are more regular in the postoperative period and had an easier intensive care path; those taking >24 hours showed more complications and their care path was longer and more complex.Conclusions. The length of preoperative stabilization does not affect mortality, but is a valid parameter to identify difficulties in survivors’ clinical pathway.

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