Long-term Outcomes of Congenital Diaphragmatic Hernia Repair A Retrospective cohort study.

Original Article

Abstract

Background : Congenital Diaphragmatic Hernia (CDH) is a type of disorder in the formation of diaphragm during embryonic and fetal development, which leads to underdevelopment of the lungs and quick fatigue while breathing in new born babies. Surgery is necessary, and still, the patient can have respiratory, gastrointestinal and neurodevelopmental issues even in the future.

Objectives: To assess the pulmonary, gastrointestinal and neurodevelopmental morbidity in relation to primary surgical repair of CDH.

Study design: A Retrospective cohort study

Place and duration of study. Department of pediatric surgery mmc mardan from jan 2019 to july 2019

Methods : The current research therefore is a retrospective record-reviewing cohort study based on 150 patients with CHD who had been surgically repaired between 2005 and 2020. For identification of long term complications, clinical examinations, pulmonary function tests and neurodevelopmental tests were done on patients. The quantitative data was analyzed using mean age, and SD for age, while comparison for the outcomes with the control group was done using p-values.

Results : The study participants consisted of 150 patients of the mean age at the time of follow-up of 10. 3 years (SD = 2. 4). Pulmonary complications were noted in 45 % of the patient and the most common of them all was the reduced lung volume (p = 0. 03). Abdominal pain and/or gastric reflux was reported 30% (p = 0. 04) of the patients. Twenty five percent of patients’ had neurodevelopmental delays (p = 0. 02). The findings revealed that patients who had birth with severe lung hypoplasia were the ones who had complications in the long-run. These complications were becoming less lethal but yet they were adversely affecting the quality of the lives of the patients.

Conclusion : CDH repair results in increased survival, however long term follow up shows that significant morbidities persist and occur predominantly in the respiratory, gastrointestinal and neurodevelopmental systems. These are some of the issues that work ought to concentrate on assuming their patients’ well-being is to be enhanced; fundamentally, they must be distinguished and addressed at an early stage.

Keywords: Ehlers–Danlos syndrome, genotype–phenotype correlation, cardiac manifestations, prognosis