Appropriate timing of surgery for neonates with congenital diaphragmatic hernia: early or delayed repair?

摘要: This study was aimed to evaluate the influence of timing surgery on patient outcomes, and clarify appropriate in neonates with congenital diaphragmatic hernia (CDH). A total 477 isolated CDH were included. Patients classified into two groups by surgery: early repair (ER) (≤48 h) delayed (DR) (>48 h). The primary outcome 90-day survival, treatment duration (ventilation, oxygen, hospitalization) being a secondary outcome. To adjust for disease severity, patients stratified three severities Apgar score 1 min (“mild” 8–10, “moderate” 4–7, “severe” 0–3), outcomes compared between ER DR within each severity. Although survival significantly different among 97%, 89%, 76%, p = 0.002), there no differences In “mild”, DR. “moderate”, shorter than (ventilation 11 vs. 16 days, oxygen 15 20 days, hospitalization 34 48 days). “severe”, DR, while best OI higher ER. Timing seems have regardless moderate severity may benefit from reducing duration.