Appropriate timing of surgery for neonates with congenital diaphragmatic hernia: early or delayed repair?

Japanese CDH study group

Research output: Contribution to journalArticle

2 Citations (Scopus)

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 languageEnglish
Pages (from-to)133-138
Number of pages6
JournalPediatric surgery international
Volume33
Issue number2
DOIs
Publication statusPublished - Feb 1 2017

Fingerprint

Newborn Infant
Survival
Ventilation
Hospitalization
Oxygen
Therapeutics
Apgar Score
Herniorrhaphy
Congenital Diaphragmatic Hernias

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 journalArticle

@article{6a298f0d0bca457dad4ca554057eaa27,
title = "Appropriate timing of surgery for neonates with congenital diaphragmatic hernia: early or delayed repair?",
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.",
author = "{Japanese CDH study group} and Hiroomi Okuyama and Noriaki Usui and Masahiro Hayakawa and Tomoaki Taguchi",
year = "2017",
month = "2",
day = "1",
doi = "10.1007/s00383-016-4003-1",
language = "English",
volume = "33",
pages = "133--138",
journal = "Pediatric Surgery International",
issn = "0179-0358",
publisher = "Springer Verlag",
number = "2",

}

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 -