Kamal Ali1, Theodore Dassios1,2, Syed Abdul Khaliq1, Emma E Williams2, Kentaro Tamura1,3, Mark Davenport4, Anne Greenough5,6,7,8. 1. Neonatal Intensive Care Centre, 4th Floor Golden Jubilee Wing, King's College Hospital NHS Foundation Trust, Denmark Hill, London, SE5 9RS, UK. 2. Women and Children's Health, School of Life Course Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK. 3. Division of Neonatology, Maternal and Perinatal Centre, Toyama University Hospital, Toyama, Japan. 4. Department of Paediatric Surgery, King's College Hospital NHS Foundation Trust, London, UK. 5. Neonatal Intensive Care Centre, 4th Floor Golden Jubilee Wing, King's College Hospital NHS Foundation Trust, Denmark Hill, London, SE5 9RS, UK. anne.greenough@kcl.ac.uk. 6. Women and Children's Health, School of Life Course Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK. anne.greenough@kcl.ac.uk. 7. The Asthma UK Centre for Allergic Mechanisms of Asthma, King's College London, London, UK. anne.greenough@kcl.ac.uk. 8. NIHR Biomedical Centre at Guy's and St Thomas NHS Foundation Trust and King's College London, London, UK. anne.greenough@kcl.ac.uk.
Abstract
PURPOSE: To compare the outcomes of infants with a right (RCDH) versus a left-sided (LCDH) congenital diaphragmatic hernia (CDH) and whether these differed according to whether the infants had undergone fetoscopic tracheal occlusion (FETO). METHODS: Demographics, the type of surgical repair, preoperative and postoperative courses and respiratory, gastrointestinal, surgical and skeletal morbidities at follow-up were compared between infants with a RCDH or LCDH. A sub-analysis was undertaken in those who had undergone FETO. RESULTS: During the study period, there were 167 infants with a LCDH and 24 with a RCDH; 106 underwent FETO (15 RCDH). Overall, the need for inhaled nitric oxide (p = 0.036) was higher in the RCDH group and, at follow-up, infants with RCDH were more likely to have a hernia recurrence (p = 0.043), pectus deformity (p = 0.019), scoliosis (p = 0.029) and suffer chronic respiratory morbidity (p = 0.001). There were, however, no significant differences in short term or long term outcomes (hernia recurrence (p = 0.237), pectus deformity (p = 0.322), scoliosis (p = 0.0174) or chronic respiratory morbidity (p = 0.326)) between infants with a right or left sided CDH who had undergone FETO. CONCLUSION: Overall, infants with a RCDH compared to those with a LCDH had greater long-term morbidity, but not if they had undergone FETO.
PURPOSE: To compare the outcomes of infants with a right (RCDH) versus a left-sided (LCDH) congenital diaphragmatic hernia (CDH) and whether these differed according to whether the infants had undergone fetoscopic tracheal occlusion (FETO). METHODS: Demographics, the type of surgical repair, preoperative and postoperative courses and respiratory, gastrointestinal, surgical and skeletal morbidities at follow-up were compared between infants with a RCDH or LCDH. A sub-analysis was undertaken in those who had undergone FETO. RESULTS: During the study period, there were 167 infants with a LCDH and 24 with a RCDH; 106 underwent FETO (15 RCDH). Overall, the need for inhaled nitric oxide (p = 0.036) was higher in the RCDH group and, at follow-up, infants with RCDH were more likely to have a hernia recurrence (p = 0.043), pectus deformity (p = 0.019), scoliosis (p = 0.029) and suffer chronic respiratory morbidity (p = 0.001). There were, however, no significant differences in short term or long term outcomes (hernia recurrence (p = 0.237), pectus deformity (p = 0.322), scoliosis (p = 0.0174) or chronic respiratory morbidity (p = 0.326)) between infants with a right or left sided CDH who had undergone FETO. CONCLUSION: Overall, infants with a RCDH compared to those with a LCDH had greater long-term morbidity, but not if they had undergone FETO.
Authors: Abigail Wilpers; Anna Y Lynn; Barbara Eichhorn; Amy B Powne; Megan Lagueux; Janene Batten; Mert Ozan Bahtiyar; Cary P Gross Journal: Fetal Diagn Ther Date: 2022-03-10 Impact factor: 2.208
Authors: Francesco Macchini; Genny Raffaeli; Ilaria Amodeo; Martina Ichino; José Luis Encinas; Leopoldo Martinez; Lucas Wessel; Giacomo Cavallaro Journal: Front Pediatr Date: 2022-02-09 Impact factor: 3.418