Appropriate timing of surgery for neonates with congenital diaphragmatic hernia: early or delayed repair? View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2016-11-07

AUTHORS

Hiroomi Okuyama, Noriaki Usui, Masahiro Hayakawa, Tomoaki Taguchi, Japanese CDH study group

ABSTRACT

PurposeThis study was aimed to evaluate the influence of timing of surgery on patient outcomes, and to clarify appropriate timing of surgery in neonates with congenital diaphragmatic hernia (CDH).MethodsA total of 477 neonates with isolated CDH were included. Patients were classified into two groups by timing of surgery: early repair (ER) (≤48 h) and delayed repair (DR) (>48 h). The primary outcome was 90-day survival, with treatment duration (ventilation, oxygen, and hospitalization) being a secondary outcome. To adjust for disease severity, patients were stratified into three severities by Apgar score 1 min (“mild” 8–10, “moderate” 4–7, and “severe” 0–3), and outcomes were compared between ER and DR within each severity.ResultsAlthough 90-day survival was significantly different among the three severities (“mild” 97%, “moderate” 89%, and “severe” 76%, p = 0.002), there were no differences in 90-day survival between DR and ER within each severity. In “mild”, there were no differences in treatment duration between ER and DR. In “moderate”, treatment duration was shorter in ER than DR (ventilation 11 vs. 16 days, oxygen 15 vs. 20 days, and hospitalization 34 vs. 48 days). In “severe”, treatment duration was shorter in ER than DR, while the best OI was higher in DR than ER.ConclusionsTiming of CDH repair seems to have no influence on 90-day survival regardless of disease severity. Patients with moderate severity may benefit from the early repair by reducing treatment duration. More... »

PAGES

133-138

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00383-016-4003-1

DOI

http://dx.doi.org/10.1007/s00383-016-4003-1

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1025749204

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/27822779


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183 rdf:type schema:Organization
184 grid-institutes:grid.416629.e schema:alternateName Department of Pediatric Surgery, Osaka Medical Center and Research Institute for Maternal and Child Health, Osaka, Japan
185 schema:name Department of Pediatric Surgery, Osaka Medical Center and Research Institute for Maternal and Child Health, Osaka, Japan
186 rdf:type schema:Organization
187 grid-institutes:grid.437848.4 schema:alternateName Division of Neonatology, Center for Maternal-Neonatal Care, Nagoya University Hospital, Nagoya, Japan
188 schema:name Division of Neonatology, Center for Maternal-Neonatal Care, Nagoya University Hospital, Nagoya, Japan
189 rdf:type schema:Organization
 




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