Abstract
During the period between 1973 and 1989, 26 patients with left sided congenital diaphragmatic hernia (CDH) were operated upon within 24 hours after birth at Kobe Children's Hospital. The stomach was located in the chest (group A) in 18 patients, whereas the stomach in the abdomen in 8 patients (group B). We compared the mortality, associated anomalies, the time requiring endotracheal intubation, incidentce of persistent fetal circulation (PFC), and postoperative PaC0_2/Ventilation Index between the two groups. The mortality rate was 44.4% in group A, and 16.7% in group B. Each of the dead cases revealed severe pathological conditions, eg. congenital heart diseases, TEF, tracheomalacia, or congenital cytomegalovirus infection, etc. The time requiring respiratory management ranged from 0 day to 39 days (mean 15days) in group A, and 2 days to 7 days (mean 4 days) in group B. PFC occurred in 75% in group A, but none in group B (p<0.01). According to PaC0_2/Ventilation Index, seven of 15 cases belonged to high-risk group in group A, and only one of 8 cases was seen in group B. The stomach in the chest in CDH is a significant sign of poor outcome.
