2017 Volume 53 Issue 5 Pages 998-1003
Purpose: The purpose of this study was to compare the outcomes and prognosis factors between right-sided congenital diaphragmatic hernia (RCDH) and left-sided congenital diaphragmatic hernia (LCDH) and to elucidate the characteristics and outcomes of RCDH.
Methods: We retrospectively reviewed the medical records of 39 consecutive infants with CDH from January 2002 to December 2014. The analysis focused on the prenatal diagnosis, delivery institute, the length of hospital stay, complications, and mortality in infants with RCDH and compared with those with LCDH.
Results: Seven infants had RCDH. No significant differences were observed in the characteristics between the RCDH and LCDH infants except the liver up rate (RCDH, 100.0% vs LCDH, 21.9%; p < 0.001). Postoperative gastroesophageal reflux requiring management occurred in five infants with LCDH, but in none of the infants with RCDH (15.6% vs 0.0%, respectively; p = 0.561). The survival rate of infants with RCDH was 57.1%, and that of infants with LCDH was 78.1% (p = 0.344). Among infants with LCDH, a prenatal diagnosis at <30 weeks, birth weight of <2,500 g, herniation of the liver into the thoracic cavity, and patch repair were associated with high mortality. Conversely, no factors were associated with mortality among infants with RCDH.
Conclusions: Although not statistically significant, the prenatal diagnosis and survival rates tended to be lower in infants with RCDH than in those with LCDH. The factors associated with prognosis in infants with LCDH were not similar to those in infants with RCDH. This study suggests that RCDH may be a pathophysiology independent of LCDH.
