Analysis of mortality and related factors in neonates with congenital diaphragmatic hernia undergoing thoracoscopic minimally invasive surgery

PAN Shou-dong; DAI Ting; JI Ying-tong; CHEN Gang; MA Li-shuang; YAN Fu-xia

doi:10.16766/j.cnki.issn.1674-4152.002006

Volume 19 Issue 7

Jul. 2021

Turn off MathJax

Article Contents

Article Navigation > Chinese Journal of General Practice > 2021 > 19(7): 1142-1146

PAN Shou-dong, DAI Ting, JI Ying-tong, CHEN Gang, MA Li-shuang, YAN Fu-xia. Analysis of mortality and related factors in neonates with congenital diaphragmatic hernia undergoing thoracoscopic minimally invasive surgery[J]. Chinese Journal of General Practice, 2021, 19(7): 1142-1146. doi: 10.16766/j.cnki.issn.1674-4152.002006

Citation:

PAN Shou-dong, DAI Ting, JI Ying-tong, CHEN Gang, MA Li-shuang, YAN Fu-xia. Analysis of mortality and related factors in neonates with congenital diaphragmatic hernia undergoing thoracoscopic minimally invasive surgery[J]. Chinese Journal of General Practice, 2021, 19(7): 1142-1146. doi: 10.16766/j.cnki.issn.1674-4152.002006

Citation:

PAN Shou-dong, DAI Ting, JI Ying-tong, CHEN Gang, MA Li-shuang, YAN Fu-xia. Analysis of mortality and related factors in neonates with congenital diaphragmatic hernia undergoing thoracoscopic minimally invasive surgery[J]. Chinese Journal of General Practice, 2021, 19(7): 1142-1146. doi: 10.16766/j.cnki.issn.1674-4152.002006

PDF( 1185 KB)

Analysis of mortality and related factors in neonates with congenital diaphragmatic hernia undergoing thoracoscopic minimally invasive surgery

doi: 10.16766/j.cnki.issn.1674-4152.002006

1.
Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China

Funds:

Z181100001718096

Received Date: 2020-11-29
Available Online: 2022-02-16

Abstract

Abstract

Objective To analyze the mortality and related factors of neonatal congenital diaphragmatic hernia (CDH) in the era of minimally invasive surgery. Minimally invasive surgery, represented by thoracoscopy, has been increasingly used for repair in neonates. Methods All neonates with CDH undergoing surgical repair in children's Hospital affiliated to Capital Institute of Pediatrics from January 2016 to December 2019, were retrospectively reviewed, and the mortality within 30 days after surgery was analyzed. The neonates were divided into survival group and death group according to whether they were survived within 30 days after surgery. The general information, preoperative, intraoperative and postoperative predictors of mortality were compared between the two groups. Results During the data collection period, a total of 50 cases of neonates with CDH underwent surgical repair in our hospital, of which 32 (64.0%) were completed with thoracoscopy. Fifteen neonates died within 30 days after surgery, and the mortality rate was 30.0%. There were significant differences in 9 factors between survival group and death group, including prenatal diagnosis before 25 weeks gestational age (P=0.006), low birth weight (< 2 500 g, P=0.029), combined with simple congenital heart disease (P=0.037), preoperative use of high-frequency oscillatory ventilation (HFOV, P < 0.001), preoperative oxygenation index (OI, P=0.007), American Society of Anesthesiologists (ASA) physical states (P=0.014), age at surgery after birth (P=0.045), open laparotomy (P < 0.001) and postoperative OI (P < 0.001). Conclusion In an era of minimally invasive surgery, neonates with CDH has a mortality rate of 30% within 30 days after surgery, mainly related to the severity of the disease itself. The potential of minimally invasive surgery on improving the outcome of neonatal diaphragmatic hernia should be further studied.
- The newborn,
- Congenital diaphragmatic hernia,
- Outcome,
- Related factors,
- Thoracoscopy

FullText(HTML)

References(20)

References

[1]	BURGOS C M, FRENCKNER B. Addressing the hidden mortality in CDH: A population-based study[J]. J Pediatr Surg, 2017, 52(4): 522-525. doi: 10.1016/j.jpedsurg.2016.09.061
[2]	WOODBURY J M, BOJANIC K, GRIZELJ R, et al. Incidence of congenital diaphragmatic hernia in Olmsted County, Minnesota: A population-based study[J]. J Matern Fetal Neonatal Med, 2019, 32(5): 742-748. doi: 10.1080/14767058.2017.1390739
[3]	李炳, 陈卫兵, 夏顺林, 等. 胸腔镜简易褥式缝合法治疗无膈肌后缘的新生儿膈疝[J]. 中国基层医药, 2020, 27(5): 550-551,554. doi: 10.3760/cma.j.issn.1008-6706.2020.05.009
[4]	SNOEK K G, REISS I K, GREENOUGH A, et al. Standardized postnatal management of infants with congenital diaphragmatic hernia in Europe: The CDH EURO Consortium consensus - 2015 update[J]. Neonatology, 2016, 110(1): 66-74. doi: 10.1159/000444210
[5]	ZANI-RUTTENSTOCK E, ZANI A, EATON S, et al. First population-based report of infants with congenital diaphragmatic hernia: 30-day outcomes from the American College of Surgeons National Quality Improvement Program[J]. Eur J Pediatr Surg, 2019, 29(1): 62-67. doi: 10.1055/s-0038-1668563
[6]	ZANI A, LAMAS-PINHEIRO R, PARABOSCHI I, et al. Intraoperative acidosis and hypercapnia during thoracoscopic repair of congenital diaphragmatic hernia and esophageal atresia/tracheoesophageal fistula[J]. Paediatr Anaesth, 2017, 27(8): 841-848. doi: 10.1111/pan.13178
[7]	GOONASEKERA C, ALI K, HICKEY A, et al. Mortality following congenital diaphragmatic hernia repair: The role of anesthesia[J]. Paediatr Anaesth, 2016, 26(12): 1197-1201. doi: 10.1111/pan.13008
[8]	LONG A M, BUNCH K J, KNIGHT M, et al. Early population-based outcomes of infants born with congenital diaphragmatic hernia[J]. Arch Dis Child Fetal Neonatal Ed, 2018, 103(6): F517-F522. doi: 10.1136/archdischild-2017-313933
[9]	BARRIERE F, MICHEL F, LOUNDOU A D, et al. One-year outcome for congenital diaphragmatic hernia: Results from the French National Register[J]. J Pediatr, 2018, 193: 204-210. doi: 10.1016/j.jpeds.2017.09.074
[10]	LONG A M, BUNCH K J, KNIGHT M, et al. One-year outcomes of infants born with congenital diaphragmatic hernia: A national population cohort study[J]. Arch Dis Child Fetal Neonatal Ed, 2019, 104(6): F643-F647. doi: 10.1136/archdischild-2018-316396
[11]	GRIZELJ R, BOJANIC K, VUKOVIC J, et al. Epidemiology and outcomes of congenital diaphragmatic hernia in Croatia: A population-based Study[J]. Paediatr Perinat Epidemiol, 2016, 30(4): 336-45. doi: 10.1111/ppe.12289
[12]	MCHONEY M, HAMMOND P. Role of ECMO in congenital diaphragmatic hernia[J]. Arch Dis Child Fetal Neonatal Ed, 2018, 103(2): F178-F181. doi: 10.1136/archdischild-2016-311707
[13]	OH C, YOUN J K, HAN J W, et al. Predicting survival of congenital diaphragmatic hernia on the first day of life[J]. World J Surg, 2019, 43(1): 282-290. doi: 10.1007/s00268-018-4780-x
[14]	DELAPLAIN P T, ZHANG L, CHEN Y, et al. Cannulating the contraindicated: Effect of low birth weight on mortality in neonates with congenital diaphragmatic hernia on extracorporeal membrane oxygenation[J]. J Pediatr Surg, 2017, 52(12): 2018-2025. doi: 10.1016/j.jpedsurg.2017.08.037
[15]	BRUNS A S, LAU P E, DHILLON G S, et al. Predictive value of oxygenation index for outcomes in left-sided congenital diaphragmatic hernia[J]. J Pediatr Surg, 2018, 53(9): 1675-1680. doi: 10.1016/j.jpedsurg.2017.12.023
[16]	AGGARWAL S, SHANTI C, LELLI J, et al. Prognostic utility of noninvasive estimates of pulmonary vascular compliance in neonates with congenital diaphragmatic hernia[J]. J Pediatr Surg, 2019, 54(3): 439-444. doi: 10.1016/j.jpedsurg.2018.08.057
[17]	SNOEK K G, CAPOLUPO I, VAN ROSMALEN J, et al. Conventional mechanical ventilation versus high-frequency oscillatory ventilation for congenital diaphragmatic hernia: A randomized clinical trial(the VICI-trial)[J]. Ann Surg, 2016, 263(5): 867-874. doi: 10.1097/SLA.0000000000001533
[18]	AIHOLE J S, GOWDRA A, JAVAREGOWDA D, et al. A clinical study on congenital diaphragmatic hernia in neonates: Our institutional experience[J]. J Indian Assoc Pediatr Surg, 2018, 23(3): 131-139. doi: 10.4103/jiaps.JIAPS_179_17
[19]	PUTNAM L R, TSAO K, LALLY K P, et al. Minimally invasive vs open congenital diaphragmatic hernia repair: Is there a superior approach?[J]. J Am Coll Surg, 2017, 224(4): 416-422. doi: 10.1016/j.jamcollsurg.2016.12.050
[20]	CRISS C N, COUGHLIN M A, MATUSKO N, et al. Outcomes for thoracoscopic versus open repair of small to moderate congenital diaphragmatic hernias[J]. J Pediatr Surg, 2018, 53(4): 635-639. doi: 10.1016/j.jpedsurg.2017.09.010

Relative Articles

Supplements(0)

Cited By

Proportional views

Proportional views

通讯作者: 陈斌, bchen63@163.com

1.
沈阳化工大学材料科学与工程学院沈阳 110142

Tables(2)

Get Citation

PDF

XML

Article Metrics

Article views (348) PDF downloads(7)

Analysis of mortality and related factors in neonates with congenital diaphragmatic hernia undergoing thoracoscopic minimally invasive surgery

doi: 10.16766/j.cnki.issn.1674-4152.002006

Abstract

References

Proportional views

Catalog

通讯作者: 陈斌, bchen63@163.com

Article Metrics

Proportional views

Related

Export File

Citation

Format

Content