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Prognostic factors of gastroesophageal reflux disease in congenital diaphragmatic hernia: a multicenter study

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Abstract

Purpose

Gastroesophageal reflux disease (GERD) is one of the concomitant problems in infants with congenital diaphragmatic hernia (CDH). We assessed risk factors of GERD in CDH patients.

Methods

The retrospective observational study for CDH infants was conducted. Cases of CDH who were born between January 2006 and December 2010, were operated in the 9 participating institutions, and survived to discharge were included. Completion of medical therapy for GERD and incidence of surgery were primary outcomes. Kaplan–Meier survival analysis and Cox proportional hazards regression were used.

Results

In 182 cases of CDH, the medical therapies for GERD were performed in 23.8 % (40/168), and were completed in 60.0 % (24/40). Prenatal detection of CDH (HR 5.87, CI 1.6–18.8, p = 0.012) and tube feeding at discharge (HR 5.04, 95 % CI 1.3–33.1, p = 0.016) were significantly correlated with unsuccessful weaning from medical therapy. Surgery for GERD was performed in 10.7 % (18/169). Gestational age (HR 4.78, 95 % CI 1.5–21.1, p = 0.006) and diaphragmatic defect of more than 75 % (HR 4.3, 95 % CI 1.6–12.9, p = 0.005) were significantly correlated with need for antireflux surgery.

Conclusion

Diaphragmatic defect of more than 75 % was risk factor of future need for antireflux surgery.

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Acknowledgments

This work was supported by a grant from the Ministry of Health, Labor and Welfare of Japan (Health and Labor Sciences Research Grants for Research on Intrac Diseases). The authors gratefully acknowledge the contributions of all the pediatric surgery and/or tertiary perinatal care centers for the collection of data for this study. We are grateful to Dr. Yasunori Sato (Clinical Research Center, Chiba University Hospital) for his supervising in statistical analyses.

Conflict of interest

The authors declare that they have no conflicts of interest.

Author information

Authors and Affiliations

  1. Department of Pediatric Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuou-ku, Chiba, 260-8677, Japan

    Keita Terui & Hideo Yoshida

  2. Department of Pediatric Surgery, Reproductive and Developmental Medicine, Graduate School of Medical Sciences, Kyushu University, Kyushu, Japan

    Tomoaki Taguchi

  3. Division of Neonatology, Department of Maternal and Perinatal Medicine, National Center for Child Health and Development, Tokyo, Japan

    Keiji Goishi

  4. Division of Neonatology, Center for Maternal-Neonatal Care, Nagoya University Hospital, Nagoya, Japan

    Masahiro Hayakawa

  5. Department of Pediatric Surgery, Osaka Medical Center and Research Institute for Maternal and Child Health, Osaka, Japan

    Yuko Tazuke & Noriaki Usui

  6. Department of Pediatric Surgery, Kobe Children’s Hospital, Kobe, Japan

    Akiko Yokoi

  7. Department of Pediatric Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan

    Hajime Takayasu

  8. Department of Pediatric Surgery, Osaka University Graduate School of Medicine, Osaka, Japan

    Hiroomi Okuyama

  9. Department of Pediatric Surgery, Hyogo College of Medicine University, Hyogo, Japan

    Hiroomi Okuyama

Authors
  1. Keita Terui
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  2. Tomoaki Taguchi
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  3. Keiji Goishi
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  4. Masahiro Hayakawa
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  5. Yuko Tazuke
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  6. Akiko Yokoi
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  7. Hajime Takayasu
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  8. Hiroomi Okuyama
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  9. Hideo Yoshida
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  10. Noriaki Usui
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Consortia

The Japanese Congenital Diaphragmatic Hernia Study Group

Corresponding author

Correspondence to Keita Terui.

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Terui, K., Taguchi, T., Goishi, K. et al. Prognostic factors of gastroesophageal reflux disease in congenital diaphragmatic hernia: a multicenter study. Pediatr Surg Int 30, 1129–1134 (2014). https://doi.org/10.1007/s00383-014-3594-7

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  • DOI: https://doi.org/10.1007/s00383-014-3594-7

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