Factors associated with early recurrence after congenital diaphragmatic hernia repair
作者： Luke R Putnam , Vikas Gupta , Kuojen Tsao , Carl F Davis , Pamela A Lally
DOI: 10.1016/J.JPEDSURG.2017.03.011
关键词: Extracorporeal membrane oxygenation 、 Laparoscopy 、 Surgery 、 Congenital diaphragmatic hernia 、 Diaphragmatic breathing 、 Thoracotomy 、 Thoracoscopy 、 Diaphragmatic hernia 、 Laparotomy 、 Medicine 、 Anesthesia
摘要: Abstract Background The purpose of this study was to identify patient and treatment characteristics associated with early (in hospital) hernia recurrence after congenital diaphragmatic (CDH) repair. Methods Data from the Congenital Diaphragmatic Hernia Study Group registry were queried 2007 2015. Recurrence initial repair prior death or discharge determined at time reoperation. Minimally invasive surgery (MIS) approaches included laparoscopy thoracoscopy, open consisted laparotomy thoracotomy. Multivariate regression analysis performed. Results Of 3984 patients, 3332 (84%) underwent CDH 76 (2.3%) patients had an recurrence. rate less variable over for undergoing vs thoracoscopy (range: 1.1–3.7% 1.7–8.9% annually). Timing repair, whether performed after, during, before ECMO did not significantly alter rates (0% 4.2% 3.0%, p =0.116). Larger defect size (C: OR 4.3, 95% CI 1.2–15.4; D: 7.1, 1.7–29.1) MIS approach (OR 3.2, 1.7–6.0) only independent predictors Conclusion higher recurrence, while use timing not. Type Treatment study. Level evidence II.
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