Rahşan ÖZCAN, Sinan CELAYİR, Gonca TEKANT, Ali Ekber HAKALMAZ, Şenol EMRE

10.5455/annalsmedres.2018.11.250

Aim: It is to determine problems in long-term follow-up of patients operated in infancy and newborn period for congenital diaphragmatic hernia in our clinic before one year of age and to evaluate significance of perioperative findings on long-term results.Material and Methods: Among patients, 16 patient above 8 years of age with outpatient control in the past year were investigated retrospectively. Patients were grouped regarding operation age as newborn and infancy period. Preoperative predictive data, early and late postoperative findings, diagnostic studies, disorders were evaluated.Results: Male-to-female ratio was 3/1, right-to-left sided hernia was 1/15. Average age was 13.1(9-17). Average follow-up was 13years (8-17 years). Thirteen patients were diagnosed in newborn period, 3 in infancy. On follow-up, 85% of newborns and 33% of infants were found to have at least one disorder. Scoliosis presented in 6, asthma in 5, gastroesophageal reflux (GER) in 4, pectus excavatum in 4, undescended testis in 3, failure to thrive in 2 patients. All the musculoskeletal system deformities were diagnosed in only newborn period patients. Four cases (25%) were uneventful. Spirometry revealed obstructive dysfunction in 1, restrictive in 2 patients. CT showed increased aeration and pulmonary asymmetry.Conclusions: Among evaluated patients, 75% showing disorders requiring treatment or observation indicates the need for follow-up until adolescence.

PDF

___

1. Lally KP, Engle W. Postdischarge follow-up of infants with congenital diaphragmatic hernia. Pediatrics 2008;121:627-32.
2. Bagolan P, Morini F. Long-term follow up of infants with congenital diaphragmatic hernia. Semin Pediatr Surg 2007;16:134-44.
3. Ilce Z, Celayir S. Modified Ventilatory Index (MVI) in newborns with congenital diaphragmatic hernia. Indian Pediatr 2003;40:920.
4. Muratore CS, Utter S, Jaksic T, et al. Nutritional morbidity in survivors of congenital diaphragmatic hernia. J Pediatr Surg 2001;36:1171-6.
5. Putnam LR, Harting MT, Tsao K, et al. Congenital Diaphragmatic Hernia Defect Size and Infant Morbidity at Discharge. Pediatrics 2016;138:e20162043.
6. Vanamo K, Peltonen J, Rintala R, et al. Chest wall and spinal deformities in adults with congenital diaphragmatic defects. J Pediatr Surg 1996;31:851-4
7. Peetsold MG, Heij HA, Kneepkens CM, et al. The long-term follow-up of patients with a congenital diaphragmatic hernia: A broad spectrum of morbidity. Pediatr Surg Int 2009;25:1-17.
8. Terui K, Nagata K, Hayakawa M, et al. Growth assessment and the risk of growth retardation in congenital diaphragmatic hernia: a long-term follow-up study from the japanese congenital diaphragmatic hernia study group. Eur J Pediatr Surg 2016;26:60-6.
9. Trachsel D, Selvadurai H, Bohn D, et al. Long-term pulmonary morbidity in survivors of congenital diaphragmatic hernia. Pediatr Pulmonol 2005;39:433-9.
10. Van Den Hout L, Sluiter I, Gischler S, et al. Can we improve outcome of congenital diaphragmatic hernia? Pediatr Surg Int 2009;25:733-43.
11. Muratore CS, Kharasch V, Lund DP, et al. Pulmonary morbidity in 100 survivors of congenital diaphragmatic hernia monitored in a multidisciplinary clinic. J Pediatr Surg 2001;36:133-40.
12. Chen F, Kubo T, Shoji T, et al. Comparison of pulmonary function test and computed tomography volumetry in living lung donors. J Hear Lung Transplant 2011;30:572-5.
13. Beals DA, Schloo BL, Vacanti JP, et al. Pulmonary growth and remodeling in infants with high-risk congenital diaphragmatic hernia. J Pediatr Surg 1992;27:997-1002.
14. Molina DK, DiMaio VJM. Normal Organ weights in men part II-the brain, lungs, liver, spleen, and kidneys. Am J Forensic Med Pathol 2011;33:368-72.