Link: http://www.ncbi.nlm.nih.gov/pubmed/25937583

Asian J Surg. 2015 Apr 30. pii: S1015-9584(15)00042-1. doi: 10.1016/j.asjsur.2015.02.005. [Epub ahead of print]

Analysis of risk factors of long-term complications in congenital diaphragmatic hernia: A single institution's experience.
Takayasu H1, Masumoto K2, Jimbo T2, Sakamoto N2, Sasaki T2, Uesugi T2, Gotoh C2, Urita Y2, Shinkai T2.
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Abstract
OBJECTIVE:
To establish better management practices to reduce morbidities in survivors with congenital diaphragmatic hernia (CDH).

METHODS:
Of 60 patients treated for CDH at our institution between 1991 and 2011, 49 patients without severe anomalies were retrospectively reviewed.

RESULTS:
Since 2004, gentle ventilation (GV) has been the main treatment for CDH. Patients were divided into the following two groups: the non-GV group (n = 29) who were treated before GV treatment was implemented, and the GV group (n = 20). The overall survival rate was 62.1% (18/29) and 95% (19/20) in the non-GV and GV groups, respectively (p = 0.016). Despite the high survival rate, the incidence of long-term complications in survivors was still high (14/19, 73.7%) in the GV group. In the GV group, liver-up (p = 0.106) and the need for patch repair (p = 0.257) tended to be associated with the development of long-term complications, but did not reach statistical significance. The presence of perioperative complications was associated with the development of long-term complications (p = 0.045) in the GV group.

CONCLUSION:
Patients who developed short-term complications seemed to be at risk of long-term complications. Therefore, to minimize long-term morbidities in CDH survivors, the prevention of short-term complications might be important.

Copyright © 2015. Published by Elsevier Taiwan.