Jun Kono1, Kouji Nagata2, Keita Terui3, Shoichiro Amari4, Katsuaki Toyoshima5, Noboru Inamura6, Yuhki Koike7, Masaya Yamoto8, Tadaharu Okazaki9, Yuta Yazaki10, Hiroomi Okuyama11, Masahiro Hayakawa12, Taizo Furukawa13, Kouji Masumoto14, Akiko Yokoi15, Noriaki Usui16, Tatsuro Tajiri1. 1. Department of Pediatric Surgery, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan. 2. Department of Pediatric Surgery, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan. nagata.koji.318@m.kyushu-u.ac.jp. 3. Department of Pediatric Surgery, Chiba University Graduate School of Medicine, Chiba, Japan. 4. Division of Neonatology, National Center for Child Health and Development, Setagaya-Ku, Japan. 5. Department of Neonatology, Kanagawa Children's Medical Center, Yokohama, Japan. 6. Department of Pediatrics, Kinki University, Higashiosaka, Japan. 7. Department of Gastrointestinal and Pediatric Surgery, Mie University Graduate School of Medicine, Tsu, Japan. 8. Department of Pediatric Surgery, Shizuoka Children's Hospital, Shizuoka, Japan. 9. Department of Pediatric Surgery, Juntendo University Urayasu Hospital, Chiba, Japan. 10. Department of Pediatric General and Urogenital Surgery, Juntendo University School of Medicine, Bunkyo-ku, Japan. 11. Department of Pediatric Surgery, Osaka University Graduate School of Medicine, Osaka, Japan. 12. Center for Maternal-Neonatal Care, Nagoya University Hospital, Nagoya, Japan. 13. Department of Pediatric Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan. 14. Department of Pediatric Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan. 15. Department of Pediatric Surgery, Hyogo Children's Hospital, Hyogo, Japan. 16. Department of Pediatric Surgery, Osaka Women's and Children's Hospital, Izumi, Japan.
Abstract
PURPOSE: The prenatal diagnosis of the stomach position in congenital diaphragmatic hernia (CDH) has been a reliable prognostic factor, but few studies have focused on the postnatal position. We therefore evaluated the significance of the nasogastric (NG) tube position just after birth. METHODS: The Japanese CDH Study Group database enrolled 1037 CDH neonates over 15 years. In our multicenter retrospective study, 464 cases of left-sided isolated CDH with prenatal diagnoses were divided into two groups: NG tube below the diaphragm (BD; n = 190) or above the diaphragm (AD; n = 274). The primary outcome was the 90-day survival rate, and the secondary outcomes were mechanical ventilation duration, hospitalization duration, and recurrence rate. RESULTS: The BD group had a significantly higher 90-day survival rate (98.4 vs. 89.4%, p < 0.001), shorter mechanical ventilation (11 vs. 19 days, p < 0.001), shorter hospitalization (38 vs. 59 days, p < 0.001), and lower recurrence rate (p = 0.002) than the AD group. A multivariate analysis showed that BD (adjusted odds ratio, 3.68; 95% confidence interval 1.02-13.30) was a favorable prognostic factor for the 90-day survival. CONCLUSION: The assessment of the NG tube position revealed it to be a reliable prognostic factor of left-sided isolated CDH. Therefore, it should be included as a routine assessment.
PURPOSE: The prenatal diagnosis of the stomach position in congenital diaphragmatic hernia (CDH) has been a reliable prognostic factor, but few studies have focused on the postnatal position. We therefore evaluated the significance of the nasogastric (NG) tube position just after birth. METHODS: The Japanese CDH Study Group database enrolled 1037 CDH neonates over 15 years. In our multicenter retrospective study, 464 cases of left-sided isolated CDH with prenatal diagnoses were divided into two groups: NG tube below the diaphragm (BD; n = 190) or above the diaphragm (AD; n = 274). The primary outcome was the 90-day survival rate, and the secondary outcomes were mechanical ventilation duration, hospitalization duration, and recurrence rate. RESULTS: The BD group had a significantly higher 90-day survival rate (98.4 vs. 89.4%, p < 0.001), shorter mechanical ventilation (11 vs. 19 days, p < 0.001), shorter hospitalization (38 vs. 59 days, p < 0.001), and lower recurrence rate (p = 0.002) than the AD group. A multivariate analysis showed that BD (adjusted odds ratio, 3.68; 95% confidence interval 1.02-13.30) was a favorable prognostic factor for the 90-day survival. CONCLUSION: The assessment of the NG tube position revealed it to be a reliable prognostic factor of left-sided isolated CDH. Therefore, it should be included as a routine assessment.
Authors: J Jani; K H Nicolaides; R L Keller; A Benachi; C F A Peralta; R Favre; O Moreno; D Tibboel; S Lipitz; A Eggink; P Vaast; K Allegaert; M Harrison; J Deprest Journal: Ultrasound Obstet Gynecol Date: 2007-07 Impact factor: 7.299
Authors: Y Kitano; H Okuyama; M Saito; N Usui; N Morikawa; K Masumoto; H Takayasu; T Nakamura; H Ishikawa; M Kawataki; S Hayashi; N Inamura; K Nose; H Sago Journal: Ultrasound Obstet Gynecol Date: 2011-03 Impact factor: 7.299
Authors: Philip Dekoninck; Eduardo Gratacos; Tim Van Mieghem; Jute Richter; Paul Lewi; Ana Martin Ancel; Karel Allegaert; Kypros Nicolaides; Jan Deprest Journal: Early Hum Dev Date: 2011-09 Impact factor: 2.079