Abstract
Purpose: Although congenital diaphragmatic hernia (CDH) is a life-threatening disease, the survival rate of CDH patients has improved owing to recent advances in neonatal management. The incidence of postoperative complications has been increasing in association with improved survival rate. The aim of this study was to investigate the incidence and characteristics of surgical complications such as recurrence, intestinal adhesive obstruction (IAO), and gastroesophageal reflux disease (GERD) with focus on the severity of CDH prenatally diagnosed.
Methods: Fifty-one surviving patients who met criteria such as prenatal diagnosis, left side, and isolated disease, were analyzed for surgical complications requiring surgical interventions.
Results: According to Kitano’s classification, 27 patients (52.9%) were classified into Group I, 14 (27.4%) into Group II, and 10 (19.7%) into Group III. The numbers of patients who required patch repair are one (3.3%) in Group I, seven (50%) in Group II, and ten (100%) in Group III. Sixteen (31%) out of 51 patients experienced 22 operations owing to recurrence in eight, IAO in six, and GERD in eight. On the basis of the severity of CDH prenatally diagnosed, surgical complications occurred in six patients (18.5%) in Group I, three (21%) in Group II, and seven (70%) in Group III. The recurrence rate and GERD incidence are significantly higher in Group III, but no significant differences were seen among the groups for IAO.
Conclusion: We analyzed surgical complications with focus on the severity of CDH prenatally diagnosed in our patients. Recurrence and GERD were observed in children with severe CDH prenatally diagnosed. Since the incidence of surgical complications is high in the group with severe CDH, careful follow-up is mandatory.
