The Result of Delayed Operation in Congenital Diaphragmatic Hernia
Journal of the Korean Association of Pediatric Surgeons
; : 21-25, 2001.
Article
in Korean
| WPRIM (Western Pacific)
| ID: wpr-25952
Responsible library:
WPRO
ABSTRACT
Congenital diaphragmatic hernia (CDH) in the past was considered a surgical emergency requiring immediate operation. Several groups now advocate preoperative stabilization and delayed surgery. The treatment strategy for CDH in this institution is delayed surgery after preoperative stabilization. The aim of this study was to evaluate the results of delayed surgery. A retrospective review of 16 neonates with CDH was performed. Surfactant, conventional mechanical ventilation, high frequency oscillation, and nitric oxide were utilized for preoperative stabilization as necessary. The difference in outcome between two groups differentiated by the duration of the preoperative stabilization periods with mechanical ventilation (8 hours) was determined. Chi-square test was used to analyze the data. There were 7 right-sided hernias and 9 left. The average duration of stabilization was 32.4 hours. Hepatic herniation through the defect was found in 6 cases and all died. The most common postoperative complication was pneumothorax. The mortality rate of the right side hernia was higher than the left (85.7% vs. 33.3%, p=0.036). Mortality rate of the group (N=8) whose preoperative stabilization period was 8 hours or less was better than that (N=6) whose preoperative stabilization period was more than 8 hours (25.0% vs. 83.3%, p=0.031). The overall mortality rate was 56.3%. The better prognosis was noticed in left side hernia, no liver herniation, or shorter preoperative stabilization period.
Full text:
Available
Health context:
SDG3 - Health and Well-Being
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SDG3 - Target 3.4 Reduce premature mortality due to noncommunicable diseases
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SDG3 - Target 3.2 Reduce avoidable death in newborns and children under 5
Health problem:
Target 3.2: Reduce avoidable death in newborns and children under 5
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Digestive System Diseases
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Other Respiratory Diseases
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Noncommunicable Diseases
Database:
WPRIM (Western Pacific)
Main subject:
Pneumothorax
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Postoperative Complications
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Prognosis
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Respiration, Artificial
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Retrospective Studies
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Mortality
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Emergencies
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Hernia
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Hernia, Diaphragmatic
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Liver
Type of study:
Observational study
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Prognostic study
Limits:
Humans
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Infant, Newborn
Language:
Korean
Journal:
Journal of the Korean Association of Pediatric Surgeons
Year:
2001
Document type:
Article