TY - JOUR
T1 - Comparative outcomes of right versus left congenital diaphragmatic hernia
T2 - A multicenter analysis
AU - Abramov, Alexey
AU - Fan, Weijia
AU - Hernan, Rebecca
AU - Zenilman, Ariela L.
AU - Wynn, Julia
AU - Aspelund, Gudrun
AU - Khlevner, Julie
AU - Krishnan, Usha
AU - Lim, Foong Yen
AU - Mychaliska, George B.
AU - Warner, Brad W.
AU - Cusick, Robert
AU - Crombleholme, Timothy
AU - Chung, Dai
AU - Danko, Melissa E.
AU - Wagner, Amy J.
AU - Azarow, Kenneth
AU - Schindel, David
AU - Potoka, Douglas
AU - Soffer, Sam
AU - Fisher, Jason
AU - McCulley, David
AU - Farkouh-Karoleski, Christiana
AU - Chung, Wendy K.
AU - Duron, Vincent
N1 - Publisher Copyright:
© 2019 Elsevier Inc.
PY - 2020/1
Y1 - 2020/1
N2 - Background: Congenital diaphragmatic hernia (CDH) occurs in 1 out of 2500–3000 live births. Right-sided CDHs (R-CDHs) comprise 25% of all CDH cases, and data are conflicting on outcomes of these patients. The aim of our study was to compare outcomes in patients with right versus left CDH (L-CDH). Methods: We analyzed a multicenter prospectively enrolled database to compare baseline characteristics and outcomes of neonates enrolled from January 2005 to January 2019 with R-CDH vs. L-CDH. Results: A total of 588, 495 L-CDH, and 93 R-CDH patients with CDH were analyzed. L-CDHs were more frequently diagnosed prenatally (p = 0.011). Lung-to-head ratio was similar in both cohorts. R-CDHs had a lower frequency of primary repair (p = 0.022) and a higher frequency of need for oxygen at discharge (p = 0.013). However, in a multivariate analysis, need for oxygen at discharge was no longer significantly different. There were no differences in long-term neurodevelopmental outcomes assessed at two year follow up. There was no difference in mortality, need for ECMO, pulmonary hypertension, or hernia recurrence. Conclusion: In this large series comparing R to L-CDH patients, we found no significant difference in mortality, use of ECMO, or pulmonary complications. Our study supports prior studies that R-CDHs are relatively larger and more often require a patch or muscle flap for repair.
AB - Background: Congenital diaphragmatic hernia (CDH) occurs in 1 out of 2500–3000 live births. Right-sided CDHs (R-CDHs) comprise 25% of all CDH cases, and data are conflicting on outcomes of these patients. The aim of our study was to compare outcomes in patients with right versus left CDH (L-CDH). Methods: We analyzed a multicenter prospectively enrolled database to compare baseline characteristics and outcomes of neonates enrolled from January 2005 to January 2019 with R-CDH vs. L-CDH. Results: A total of 588, 495 L-CDH, and 93 R-CDH patients with CDH were analyzed. L-CDHs were more frequently diagnosed prenatally (p = 0.011). Lung-to-head ratio was similar in both cohorts. R-CDHs had a lower frequency of primary repair (p = 0.022) and a higher frequency of need for oxygen at discharge (p = 0.013). However, in a multivariate analysis, need for oxygen at discharge was no longer significantly different. There were no differences in long-term neurodevelopmental outcomes assessed at two year follow up. There was no difference in mortality, need for ECMO, pulmonary hypertension, or hernia recurrence. Conclusion: In this large series comparing R to L-CDH patients, we found no significant difference in mortality, use of ECMO, or pulmonary complications. Our study supports prior studies that R-CDHs are relatively larger and more often require a patch or muscle flap for repair.
KW - Congenital diaphragmatic hernia
KW - Critical care
KW - ECMO
KW - Thoracic
UR - http://www.scopus.com/inward/record.url?scp=85074462838&partnerID=8YFLogxK
U2 - 10.1016/j.jpedsurg.2019.09.046
DO - 10.1016/j.jpedsurg.2019.09.046
M3 - Article
C2 - 31677822
AN - SCOPUS:85074462838
SN - 0022-3468
VL - 55
SP - 33
EP - 38
JO - Journal of Pediatric Surgery
JF - Journal of Pediatric Surgery
IS - 1
ER -