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Pediatric Surgery International

, Volume 28, Issue 12, pp 1177–1181 | Cite as

Trends in the treatment and outcome of congenital diaphragmatic hernia over the last decade

  • Massimo Garriboli
  • Johannes Wolfgang Duess
  • Elke Ruttenstock
  • Mark Bishay
  • Simon Eaton
  • Paolo De Coppi
  • Prem Puri
  • Michael E. Höllwarth
  • Agostino PierroEmail author
Original Article

Abstract

Purpose

Congenital diaphragmatic hernia (CDH) remains a challenging and life-threatening congenital anomaly. The aim was to evaluate whether treatment and survival has changed during the last decade.

Methods

We retrospectively analysed all consecutive infants with CDH referred to two European tertiary paediatric surgical centres over 11 years (January 1999 to December 2009). Minimum follow-up was 1 year. χ2 test for trend was used to evaluate significance.

Results

There were 234 infants. There was no significant variation over time in the proportion of infants receiving high frequency oscillatory ventilation (HFOV) (p = 0.89), inhaled nitric oxide (iNO) (p = 0.90) or extracorporeal membrane oxygenation (ECMO) (p = 0.22). 205 infants (88 %) were stabilised and underwent surgical repair; of these, 186 (79 %) survived after surgery. Over time there was a significant increase in the proportion of infants undergoing surgical repair (p = 0.018) without a concomitant significant improvement in survival (p = 0.099).

Conclusion

This multicentre analysis indicates that the survival rate of infants with CDH referred to two European paediatric surgical centres is high (79 %). The use of HFOV, iNO and ECMO has not changed in recent years. We observed a significant increase in the proportion of infants who undergo surgery but this has not resulted in a significant increase in the overall survival rate.

Keywords

Congenital diaphragmatic hernia Extracorporeal membrane oxygenation High-frequency oscillatory ventilation Inhaled nitric oxide Neonatal surgery 

Notes

Acknowledgments

Authors would like to Acknowledge the support of Mittal Foundation; MG is supported by Fondazione Alberto Mascherpa Onlus, PDC and SJE are supported by Great Ormond Street Hospital Charity.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2012

Authors and Affiliations

  • Massimo Garriboli
    • 1
  • Johannes Wolfgang Duess
    • 2
  • Elke Ruttenstock
    • 2
  • Mark Bishay
    • 1
  • Simon Eaton
    • 1
  • Paolo De Coppi
    • 1
  • Prem Puri
    • 2
  • Michael E. Höllwarth
    • 3
  • Agostino Pierro
    • 1
    Email author
  1. 1.UCL Institute of Child Health and Great Ormond Street Hospital for ChildrenLondonUK
  2. 2.National Children’s Research Centre, Our Lady’s Children’s HospitalDublinIreland
  3. 3.Department of Paediatric SurgeryMedical University of GrazGrazAustria

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