Link: https://www.ncbi.nlm.nih.gov/pubmed/30680439

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Pediatr Surg Int. 2019 Jan 24. doi: 10.1007/s00383-019-04442-z. [Epub ahead of print]
Congenital diaphragmatic hernia: the good, the bad, and the tough.
Aydin E1, Lim FY2, Kingma P3, Haberman B3, Rymeski B2, Burns P2, Peiro JL2.
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Abstract
OBJECTIVES:
We aim to determine factors that are associated with better outcomes of CDH patients.

METHODS:
A retrospective review was performed on all CDH patients admitted to our institution between 2003 and 2016. This study was performed at a single institution which has a fetal care center. Patients admitted with CDH with at least 1-year follow-up during the analysis were included in the study.

RESULTS:
Twenty-six (13.8%) patients had a hernia sac, 124 (59%) patients had liver herniation, and 56 (25.1%) patients had an accompanying syndrome. Overall survival to discharge was 73.1% while overall survival to date was 69.5%. The presence of a hernia sac, liver herniation, and accompanying syndromes showed as independent predictors influencing the survival, B 1.968, p = 0.04, OR 7.158, 95% CI 0.907-56.485, B - 1.178, p = 0.01, OR 3.932, 95% CI 1.798-8.602 and B - 1.032, p = 0.05, OR 2.795, 95% CI 0.976-7.764, respectively.

CONCLUSION:
In our CDH cohort, the presence of a hernia sac was proven to be associated with better outcomes, while thoracic herniation of the liver was associated with worse outcomes. The accompanying syndromes although being more difficult to manage had a little effect on the outcome of the disease itself.

KEYWORDS:
Cardiac anomalies; Congenital diaphragmatic hernia; Hernia sac; Liver herniation; Prognostic factors; Syndrome

PMID: 30680439 DOI: 10.1007/s00383-019-04442-z