DOI: http://dx.doi.org/10.18203/2349-2902.isj20201517

Evaluation of long term outcome of congenital diaphragmatic hernia survivors: a single centre 8 years’ experience in a developing nation with limited facilities

Natasha L. Vageriya, Rasik Shah, Shivaji B. Mane, Taha Daginawala, Prathamesh More

Abstract


Background: The objective of the study was to find out incidence of long term complications in congenital diaphragmatic hernia (CDH) survivors in a developing nation with limited facilities.

Methods: A retrospective study was done on patients who underwent CDH repair at our institution from 2012 to 2019. 71 patients were identified of these 55 patients operated in neonatal age were considered. After applying exclusion criteria 42 patients included in the study were then divided in 2 groups. Group 1 (26 patients): neonates requiring ventilation within 6 hrs of birth and group 2 (16 patients): not requiring ventilation or intubated after 6hrs of birth. Data from medical records were supplemented by a questionnaire regarding perceived physical function and medical follow up till date. Respiratory, central nervous, musculoskeletal and gastrointestinal systems were concentrated upon and questionnaire set. These were then compared with respect to their long term outcomes. Also, overall incidence of these in the two groups combined was noted compared with other studies.

Results: On comparing these 2 groups incidence of long term complications was found more in group 1; however on statistical analysis difference was not significant. As also incidence of individual long term complications in all patients together were identical or lower than in other published series. Mortality in our study was 8 of 49 neonates which was 17% of all patients presenting with CDH or born at our centre.

Conclusions: Despite the growing population of CDH survivors the morbidity is not very significant and most patients lead a normal average active life.


Keywords


Long term complications, Congenital diaphragmatic hernia, CDH sequelae

Full Text:

PDF

References


Peetsold MG, Heij HA, Kneepkens CMF, Nagelkerke AF, Huisman J, Gemke RJBJ. The long-term follow-up of patients with a congenital diaphragmatic hernia: a broad spectrum of morbidity. Pediatric Surg Int. 2009;25:1-17.

Öst E, Öjmyr Joelsson M, Mesas Burgos C, Frenckner B. Self-assessed physical health among children with congenital diaphragmatic hernia. Pediatric Surg Int. 2016;32(5):493-503.

Öst E, Frenckner B, Nisell M, Mesas Burgos C, Öjmyr Joelsson M. Health-related quality of life in children born with congenital diaphragmatic hernia. Pediatric Surg Int. 2018;34(4):405-14.

Schwartz IP, Bernbaum JC, Rychik J, Grunstein M, D’Agostino J, Polin RA. Pulmonary hypertension in children following extracorporeal membrane oxygenation therapy and repair of congenital diaphragmatic hernia. J Perinatol. 1999;19(3):220-6.

Iocono JA, Cilley RE, Mauger DT, Krummel TM, Dillon PW. Postnatal pulmonary hypertension after repair of congenital diaphragmatic hernia: predicting risk and outcome. J Pediatr Surg. 1999;34(2):349-53.

Fasching G, Huber A, Uray E, Sorantin E, Lindbichler F, Mayr J. Gastro esophageal reflux and diaphragmatic motility after repair of congenital diaphragmatic hernia. Eur J Pediatr Surg. 2000;10(6):360-4.

Koot VC, Bergmeijer JH, Bos AP, Molenaar JC. Incidence and management of gastro esophageal reflux after repair of congenital diaphragmatic hernia. J Pediatr Surg. 1993;28(1):48-52.

Vanamo K, Rintala RJ, Lindahl H, Louhimo I. Long-term gastrointestinal morbidity in patients with congenital diaphragmatic defects. J Pediatr Surg. 1996;31(4):551-4.

Nobuhara KK, Lund DP, Mitchell J, Kharasch V, Wilson JM. Long-term outlook for survivors of congenital diaphragmatic hernia. Clin Perinatol. 1996;23(4):873-87.

Hendricks-Munoz KD, Walton JP. Hearing loss in infants with persistent fetal circulation. Pediatrics. 1998;81(5):650-6.

Walton JP, Hendricks-Munoz K. Profile and stability of sensorineural hearing loss in persistent pulmonary hypertension of the newborn. J Speech Hear Res. 1991;34(6):1362-70.

Lund DP, Mitchell J, Kharasch V, Quigley S, Kuehn M, Wilson JM. Congenital diaphragmatic hernia: the hidden morbidity. J Pediatr Surg. 1994;29(2):258-62.

Danzer E, Gerdes M, Bernbaum J, D’Agostino J, Bebbington MW, Siegle J, et al. Neurodevelopmental outcome of infants with congenital diaphragmatic hernia prospectively enrolled in an interdisciplinary follow-up program. J Pediatr Surg. 2010;45:1759-66.

Morini F, Capolupo I, Masi R, Ronchetti MP, Locatelli M, Corchia C, et al. Hearing impairment in congenital diaphragmatic hernia: the inaudible and noiseless foot of time. J Pediatr Surg. 2008;43(2):380-4.