Abstract
Purpose: This study was aimed to evaluate the influence of timing of surgery on patient outcomes, and to clarify appropriate timing of surgery in neonates with congenital diaphragmatic hernia (CDH). Methods: A total of 477 neonates with isolated CDH were included. Patients were classified into two groups by timing of surgery: early repair (ER) (≤48 h) and delayed repair (DR) (>48 h). The primary outcome was 90-day survival, with treatment duration (ventilation, oxygen, and hospitalization) being a secondary outcome. To adjust for disease severity, patients were stratified into three severities by Apgar score 1 min (“mild” 8–10, “moderate” 4–7, and “severe” 0–3), and outcomes were compared between ER and DR within each severity. Results: Although 90-day survival was significantly different among the three severities (“mild” 97%, “moderate” 89%, and “severe” 76%, p = 0.002), there were no differences in 90-day survival between DR and ER within each severity. In “mild”, there were no differences in treatment duration between ER and DR. In “moderate”, treatment duration was shorter in ER than DR (ventilation 11 vs. 16 days, oxygen 15 vs. 20 days, and hospitalization 34 vs. 48 days). In “severe”, treatment duration was shorter in ER than DR, while the best OI was higher in DR than ER. Conclusions: Timing of CDH repair seems to have no influence on 90-day survival regardless of disease severity. Patients with moderate severity may benefit from the early repair by reducing treatment duration.
| Original language | English |
|---|---|
| Pages (from-to) | 133-138 |
| Number of pages | 6 |
| Journal | Pediatric surgery international |
| Volume | 33 |
| Issue number | 2 |
| DOIs | |
| Publication status | Published - Feb 1 2017 |
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All Science Journal Classification (ASJC) codes
- Pediatrics, Perinatology, and Child Health
- Surgery
Cite this
Appropriate timing of surgery for neonates with congenital diaphragmatic hernia : early or delayed repair? / Japanese CDH study group.
In: Pediatric surgery international, Vol. 33, No. 2, 01.02.2017, p. 133-138.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Appropriate timing of surgery for neonates with congenital diaphragmatic hernia
T2 - early or delayed repair?
AU - Japanese CDH study group
AU - Okuyama, Hiroomi
AU - Usui, Noriaki
AU - Hayakawa, Masahiro
AU - Taguchi, Tomoaki
PY - 2017/2/1
Y1 - 2017/2/1
N2 - Purpose: This study was aimed to evaluate the influence of timing of surgery on patient outcomes, and to clarify appropriate timing of surgery in neonates with congenital diaphragmatic hernia (CDH). Methods: A total of 477 neonates with isolated CDH were included. Patients were classified into two groups by timing of surgery: early repair (ER) (≤48 h) and delayed repair (DR) (>48 h). The primary outcome was 90-day survival, with treatment duration (ventilation, oxygen, and hospitalization) being a secondary outcome. To adjust for disease severity, patients were stratified into three severities by Apgar score 1 min (“mild” 8–10, “moderate” 4–7, and “severe” 0–3), and outcomes were compared between ER and DR within each severity. Results: Although 90-day survival was significantly different among the three severities (“mild” 97%, “moderate” 89%, and “severe” 76%, p = 0.002), there were no differences in 90-day survival between DR and ER within each severity. In “mild”, there were no differences in treatment duration between ER and DR. In “moderate”, treatment duration was shorter in ER than DR (ventilation 11 vs. 16 days, oxygen 15 vs. 20 days, and hospitalization 34 vs. 48 days). In “severe”, treatment duration was shorter in ER than DR, while the best OI was higher in DR than ER. Conclusions: Timing of CDH repair seems to have no influence on 90-day survival regardless of disease severity. Patients with moderate severity may benefit from the early repair by reducing treatment duration.
AB - Purpose: This study was aimed to evaluate the influence of timing of surgery on patient outcomes, and to clarify appropriate timing of surgery in neonates with congenital diaphragmatic hernia (CDH). Methods: A total of 477 neonates with isolated CDH were included. Patients were classified into two groups by timing of surgery: early repair (ER) (≤48 h) and delayed repair (DR) (>48 h). The primary outcome was 90-day survival, with treatment duration (ventilation, oxygen, and hospitalization) being a secondary outcome. To adjust for disease severity, patients were stratified into three severities by Apgar score 1 min (“mild” 8–10, “moderate” 4–7, and “severe” 0–3), and outcomes were compared between ER and DR within each severity. Results: Although 90-day survival was significantly different among the three severities (“mild” 97%, “moderate” 89%, and “severe” 76%, p = 0.002), there were no differences in 90-day survival between DR and ER within each severity. In “mild”, there were no differences in treatment duration between ER and DR. In “moderate”, treatment duration was shorter in ER than DR (ventilation 11 vs. 16 days, oxygen 15 vs. 20 days, and hospitalization 34 vs. 48 days). In “severe”, treatment duration was shorter in ER than DR, while the best OI was higher in DR than ER. Conclusions: Timing of CDH repair seems to have no influence on 90-day survival regardless of disease severity. Patients with moderate severity may benefit from the early repair by reducing treatment duration.
UR - http://www.scopus.com/inward/record.url?scp=84994453233&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84994453233&partnerID=8YFLogxK
U2 - 10.1007/s00383-016-4003-1
DO - 10.1007/s00383-016-4003-1
M3 - Article
C2 - 27822779
AN - SCOPUS:84994453233
VL - 33
SP - 133
EP - 138
JO - Pediatric Surgery International
JF - Pediatric Surgery International
SN - 0179-0358
IS - 2
ER -