Outcomes for Congenital Diaphragmatic Hernia in Three Decades: A Report From a UK Surgical Centre

Lee, WT ORCID: 0009-0000-0907-3335 and Losty, PD ORCID: 0000-0003-0841-5879 (2026) Outcomes for Congenital Diaphragmatic Hernia in Three Decades: A Report From a UK Surgical Centre Acta Paediatrica International Journal of Paediatrics, 115 (1). pp. 174-180. ISSN 0803-5253, 1651-2227

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Abstract

Aims: Congenital diaphragmatic hernia (CDH) is associated with lung hypoplasia, pulmonary hypertension and high mortality. Three decades experience from a UK centre is reported. Methods: Medical records of CDH newborns between February 1990 and November 2021 and attending a multidisciplinary clinic were examined. Survival and health outcomes are recorded. Results: Of 220 CDH newborns, left-sided defects were 177 (80%) cases. Diaphragm patch was required in 91 (41%) patients and 42 (19%) additionally required abdominal wall prosthesis. Materials deployed included Gore-Tex biological Surgisis patches all had early recurrences. Diaphragmatic patch was significantly associated with fundoplication (p 0.005). Overall survival rate was 85%—(90% survival primary defect vs. 79% patch) (p 0.035). Comparing decades, the post-2010 CDH study cohort was a sicker patient group comprising more index cases with cardiac malformations (69% vs. 28%, p < 0.001) requiring greater cardiovascular inotrope support (61% vs. 25%, p < 0.001) and ECMO (15% vs. 5%, p 0.023). Conclusion: While a modestly excellent 85% survival rate is reported over three decades, CDH management at this UK university surgical centre witnessed a growing complexity of patients with mixed severity phenotype(s). Future challenges remain to be solved to improve survival for the most complex vulnerable patients.

Item Type:	Article
Uncontrolled Keywords:	congenital diaphragmatic hernia, multidisciplinary clinic, patch, primary repair, survivorship
Divisions:	Faculty of Health & Life Sciences Faculty of Health & Life Sciences > Inst. Systems, Molec & Integrative Biology > Inst. Systems, Molec & Integrative Biology
Depositing User:	Symplectic Admin
Date Deposited:	16 Sep 2025 10:04
Last Modified:	28 Feb 2026 01:13
DOI:	10.1111/apa.70295
Open Access URL:	https://doi.org/10.1111/apa.70295
Related Websites:	Author Publisher
URI:	https://livrepository.liverpool.ac.uk/id/eprint/3194443
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