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Surgical complications, especially gastroesophageal reflux disease, intestinal adhesion obstruction, and diaphragmatic hernia recurrence, are major sequelae in survivors of congenital diaphragmatic hernia

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Abstract

Purpose

This study aimed to characterize the surgical complications, especially gastroesophageal reflux disease (GERD), intestinal adhesion obstruction (IAO), and diaphragmatic hernia recurrence, in patients with congenital diaphragmatic hernia (CDH).

Methods

Between January 1995 and December 2013, we determined the incidence of surgical complications and their predictors in CDH patients. We also examined whether the CDH repair and patch closure were associated with the incidence of IAO and the severity of adhesion.

Results

Seventy-four CDH survivors were evaluated. GERD occurred in 28 patients (37.8 %) and recurred in 8 patients (10.8 %). Stomach herniation was a risk factor for GERD, and occurred in 25 patients. IAO occurred in 13 patients (17.6 %). In 240 neonatal laparotomies in the same period, the incidence of IAO was significantly higher in patients who underwent CDH repair than in patients who underwent other neonatal laparotomy (p = 0.023). Surgical time and intraoperative bleeding were significantly greater following CDH repair with an artificial patch compared with CDH repair with direct closure.

Conclusion

Surgical complications are major sequelae in survivors of CDH repair. CDH repair and artificial patch closure were significantly associated with the incidence of IAO and the severity of adhesion.

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References

  1. Boloker J, Bateman DA, Wung JT, Stolar CJ (2002) Congenital diaphragmatic hernia in 120 infants treated consecutively with permissive hypercapnea/spontaneous respiration/elective repair. J Pediatr Surg 37:357–366. doi:10.1053/jpsu.2002.30834

    Article  PubMed  Google Scholar 

  2. Downard CD, Jaksic T, Garza JJ, Dzakovic A, Nemes L, Jennings RW, Wilson JM (2003) Analysis of an improved survival rate for congenital diaphragmatic hernia. J Pediatr Surg 38:729–732. doi:10.1016/jpsu.2003.50194

    Article  PubMed  Google Scholar 

  3. Javid PJ, Jaksic T, Skarsgard ED, Lee S (2004) Survival rate in congenital diaphragmatic hernia: the experience of the Canadian Neonatal Network. J Pediatr Surg 39:657–660. doi:10.1016/j.jpedsurg.2004.01.022

    Article  PubMed  Google Scholar 

  4. Chiu P, Sauer C, Mihailovic A, Adatia I, Bohn D, Coates AL, Langer JC (2006) The price of success in the management of congenital diaphragmatic hernia: is improved survival accompanied by an increase in long-term morbidity. J Pediatr Surg 41:888–892. doi:10.1016/j.jpedsurg.2006.01.026

    Article  PubMed  Google Scholar 

  5. Chiu P, Hedrick HL (2008) Postnatal management and long-term outcome for survivors with congenital diaphragmatic hernia. Prenat Diagn 28:592–603. doi:10.1002/pd.2007

    Article  PubMed  Google Scholar 

  6. Bagolan P, Morini F (2007) Long-term follow up of infants with congenital diaphragmatic hernia. Semin Pediatr Surg 16:134–144

    Article  PubMed  Google Scholar 

  7. Jancelewicz T, Vu LT, Keller RL, Bratton B, Lee H, Farmer D, Harrison M, Miniati D, Mackenzie T, Hirose S, Nobuhara K (2010) Long-term surgical outcomes in congenital diaphragmatic hernia: observations from a single institution. J Pediatr Surg 45:155–160. doi:10.1016/j.jpedsurg.2009.10.028

    Article  PubMed  Google Scholar 

  8. Lally KP, Engle W (2008) Postdischarge follow-up of infants with congenital diaphragmatic hernia. Pediatrics 121:627–632. doi:10.1542/peds.2007-3282

    Article  PubMed  Google Scholar 

  9. Lund DP, Mitchell J, Kharasch V, Quigley S, Kuehn M, Wilson JM (1994) Congenital diaphragmatic hernia: the hidden morbidity. J Pediatr Surg 29:258–264. doi:10.1016/0022-3468(94)90329-8

    Article  CAS  PubMed  Google Scholar 

  10. St Peter SD, Valusek PA, Tsao K, Holcomb GW 3rd, Ostlie DJ, Snyder CL (2007) Abdominal complications related to type of repair for congenital diaphragmatic hernia. J Surg Res 140:234–236. doi:10.1016/j.jss.2007.03.018

    Article  PubMed  Google Scholar 

  11. Peetsold MG, Heij HA, Kneepkens CM, Nagelkerke AF, Huisman J, Gemke RJ (2009) The long-term follow-up patients with a congenital diaphragmatic hernia: a broad spectrum of morbidity. Pediatr Surg Int 25:1–17. doi:10.1007/s00383-008-2257-y

    Article  CAS  PubMed  Google Scholar 

  12. Koivusalo AI, Pakarinen MP, Lindahl HG, Rintala RJ (2008) The cumulative incidence of significant gastroesophageal reflux in the patients with congenital diaphragmatic hernia—a systematic clinical, pH-metric, and endoscopic follow-up study. J Pediatr Surg 43:279–282. doi:10.1016/j.jpedsurg.2007.10.014

    Article  PubMed  Google Scholar 

  13. Arena F, Romeo C, Baldari S, Arena S, Antonuccio P, Campennì A, Zuccarello B, Romeo G (2008) Gastrointestinal sequelae in survivors of congenital diaphragmatic hernia. Pediatr Int 50:76–80. doi:10.1111/j.1442-200X.2007.02527.x

    Article  PubMed  Google Scholar 

  14. Vanamo K, Rintala RJ, Lindahl H, Louhimo I (1996) Long-term gastrointestinal morbidity in patients with congenital diaphragmatic defects. J Pediatr Surg 31:551–554. doi:10.1016/S0022-3468(96)90494-7

    Article  CAS  PubMed  Google Scholar 

  15. Kieffer J, Sapin E, Berg A, Beaudoin S, Bargy F, Helardot PG (1995) Gastroesophageal reflux after repair of congenital diaphragmatic hernia. J Pediatr Surg 30:1330–1333. doi:10.1016/0022-3468(95)90497-2

    Article  CAS  PubMed  Google Scholar 

  16. Festen C (1982) Postoperative small bowel obstruction in infants and children. Ann Surg 196:580–583

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  17. Janik JS, Ein SH, Filler RM, Shandling B, Simpson JS, Stephens CA (1981) An assessment of the surgical treatment of adhesive small bowel obstruction in infants and children. J Pediatr Surg 16:225–235

    Article  CAS  PubMed  Google Scholar 

  18. Choudhry MS, Grant HW (2006) Small bowel obstruction due to adhesions following neonatal laparotomy. Pediatr Surg Int 22:729–732. doi:10.1007/s00383-006-1719-3

    Article  PubMed  Google Scholar 

  19. Koziarkiewicz M, Taczalska A, Piaseczna-Piotrowska A (2013) Long-term follow-up of children with congenital diaphragmatic hernia—observations from a single institution. Eur J Pediatr Surg. doi:10.1055/s-0033-1357751

    PubMed  Google Scholar 

  20. Diamond IR, Mah K, Kim PC, Bohn D, Gerstle JT, Wales PW (2007) Predicting the need for fundoplication at the time of congenital diaphragmatic hernia repair. J Pediatr Surg 42:1066–1070. doi:10.1016/j.jpedsurg.2007.01.046

    Article  PubMed  Google Scholar 

  21. Su W, Berry M, Puligandla PS, Aspirot A, Flageole H, Laberge JM (2007) Predictors of gastroesophageal reflux in neonates with congenital diaphragmatic hernia. J Pediatr Surg 42:1639–1643. doi:10.1016/j.jpedsurg.2007.05.016

    Article  PubMed  Google Scholar 

  22. Kamiyama M, Kawahara H, Okuyama H, Oue T, Kuroda S, Kubota A, Okada A (2002) Gastroesophageal reflux after repair of congenital diaphragmatic hernia. J Pediatr Surg 37:1681–1684. doi:10.1053/jpsu.2002.36693

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Pediatric Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai, Showa, Nagoya, 466-8550, Japan

    Kazuki Yokota, Hiroo Uchida, Kenichiro Kaneko, Yasuyuki Ono, Naruhiko Murase & Satoshi Makita

  2. Division of Neonatology, Center for Maternal-Neonatal Care, Nagoya University Hospital, 65 Tsurumai, Showa, Nagoya, 466-8550, Japan

    Masahiro Hayakawa

Authors
  1. Kazuki Yokota
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  2. Hiroo Uchida
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  3. Kenichiro Kaneko
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  4. Yasuyuki Ono
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  5. Naruhiko Murase
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  6. Satoshi Makita
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  7. Masahiro Hayakawa
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Correspondence to Hiroo Uchida.

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Yokota, K., Uchida, H., Kaneko, K. et al. Surgical complications, especially gastroesophageal reflux disease, intestinal adhesion obstruction, and diaphragmatic hernia recurrence, are major sequelae in survivors of congenital diaphragmatic hernia. Pediatr Surg Int 30, 895–899 (2014). https://doi.org/10.1007/s00383-014-3575-x

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  • DOI: https://doi.org/10.1007/s00383-014-3575-x

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