Does the Presence of a Hernia Sac Improve Survival in Newborns with Congenital Diaphragmatic Hernia? A United Kingdom Single-Center Experience

Jawaid, Wajid, Sampat, Kit and Losty, Paul D ORCID: 0000-0003-0841-5879 (2021) Does the Presence of a Hernia Sac Improve Survival in Newborns with Congenital Diaphragmatic Hernia? A United Kingdom Single-Center Experience. EUROPEAN JOURNAL OF PEDIATRIC SURGERY, 31 (03). pp. 276-281.

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Abstract

<h4>Introduction</h4> A developing body of literature suggests that the presence of a hernia sac in fetuses with congenital diaphragmatic hernia (CDH) may indicate improved prognosis. By examining a large cohort of CDH newborns admitted to a single United Kingdom specialist center, we aimed to establish if presence of hernia sac is a robust predictor of improved survival.<h4>Materials and methods</h4> All CDH patients admitted to a single center were recruited. Postneonatal presentations and Morgagni hernias were excluded. Demographics, defect type, laterality, survival, and hernia recurrence were recorded.<h4>Results</h4> In this study, 192 CDH newborns were managed from 1997 to 2017; 39 were excluded (10 Morgagni and 29 postneonatal); 22 (14%) neonates had a hernia sac. Survival in patients with a hernia sac was 21/22 (95%) versus 107/124 (86%) in cases without hernia sac (<i>p</i> = 0.2). There was no difference in hernia sac proportion by gender (male:female 15 vs. 13.2%, <i>p</i> = 0.8).<h4>Conclusion</h4> In contrast to studies showing a survival advantage, albeit with smaller patient numbers, we report a statistical nonsignificant benefit of hernia sac. Better survival outcomes at this specialist center with CDH patients without a hernia sac than reported in other published studies are likely responsible for the lack of statistical significance observed, despite a larger cohort. National and international CDH registries yielding "big data" may provide further answers on the utility of a CDH hernia sac as a new prognostic scoring tool.

Item Type:	Article
Uncontrolled Keywords:	congenital diaphragmatic hernia, hernia sac, survival
Depositing User:	Symplectic Admin
Date Deposited:	09 Jun 2020 08:02
Last Modified:	18 Jan 2023 23:49
DOI:	10.1055/s-0040-1713131
Related URLs:	Author Publisher
URI:	https://livrepository.liverpool.ac.uk/id/eprint/3089790