The results of treatment of newborns with right-sided and left-sided intrathoracic localization of the liver with diaphragmatic hernia
- Authors: Mokrushina O.G.1,2, Razumovskiy A.Y.1,2, Yudina E.V.2, Afukov I.I.1,2, Shumikhin V.S.1,2, Smirnova S.V.1,2, Zilbert E.V.1,2, Petrova L.V.2, Erokhina N.O.1,2, Halafov R.V.1,2, Svetlichnaya T.O.2
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Affiliations:
- Pirogov Russian National Research Medical University
- Filatov Children’s Hospital
- Issue: Vol 12, No 4 (2022)
- Pages: 401-410
- Section: Original Study Articles
- URL: https://ogarev-online.ru/2219-4061/article/view/233288
- DOI: https://doi.org/10.17816/psaic1291
- ID: 233288
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Abstract
BACKGROUND: The right-sided congenital diaphragmatic hernia is the rare pathology. Results of diagnostics, prognosis and treatment usally published as a collection of cases.
AIM: Comparition of treatment results of congenital diaphragmatic hernia with the liver as its content in dependancy of the side.
MATERIALS AND METHODS: We present a retrospective analysis of 50 newborn patients with congenital diaphragmatic hernia. Patiens were divided in two groups, first — with right-sided (19 patients), and second — with left-sided hernia (31 patients). Groups were compared by gender and weigth. Comparition criteria was the results of prenatal and postnatal diagnostics, intraoperative data, postoperative period, complications and outcomes.
RESULTS: We found predominance of prenatal diagnosis in the second group (48% vs 84%, p = 0,001). The lung-to-head circumference ratio were the same in both groups (0,52 in first, 0,46 in second, p = 0,058). Chance to use thoracoscopic approach in the second group was higer in 5,7 times (48% vs 84%). Postoperative period was easier in the group of right-sided congenital diaphragmatic hernia: artificial ventilation lasted on average 8 days (min 3; max 28) versus 11 (min 4; max 50) days in the first group (p = 0,036).
Hospital stay was significantly lower in the second group — 18 days (min 12; max 28), versus 50 days in the first group (min 13; max 64), p = 0,011. Recovery chance in patients with right-sided hernia was higher (45% vs 79%, confidence interval 0,059–0,814).
CONCLUSIONS: Every type of diaphragmatic hernia, including right-sided location, need to be the subgect of research of high compitantive center. Prognostic criteria for right-sided congenital diaphragmatic hernia require furter advanced study, wich is possible only in case of concentration of patients in the same center.
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##article.viewOnOriginalSite##About the authors
Olga G. Mokrushina
Pirogov Russian National Research Medical University; Filatov Children’s Hospital
Author for correspondence.
Email: mokrushina@yandex.ru
ORCID iD: 0000-0003-4444-6103
SPIN-code: 5998-7470
Dr. Sci. (Med.), Professor, Deputy medical director; Professor of Pediatric Surgery Department
Russian Federation, Moscow; MoscowAlexandr Yu. Razumovskiy
Pirogov Russian National Research Medical University; Filatov Children’s Hospital
Email: 1595105@mail.ru
ORCID iD: 0000-0002-9497-4070
SPIN-code: 3600-4701
Dr. Sci. (Med.), Corresponding member of RAS, Head of Department of Pediatric Surgery, Head of thoraco-abdominal Department
Russian Federation, Moscow; MoscowElena V. Yudina
Filatov Children’s Hospital
Email: elena-ioudina@yandex.ru
ORCID iD: 0000-0002-0157-6189
Dr. Sci. (Med.), Prenatal Diagnostics Specialist of State Budgetary Public Health Institution
Russian Federation, MoscowIvan I. Afukov
Pirogov Russian National Research Medical University; Filatov Children’s Hospital
Email: afukovdoc@yandex.ru
ORCID iD: 0000-0001-9850-6779
SPIN-code: 4284-4702
Cand. Sci. (Med.), Deputy Medical Director, resuscitator, Assistant Professor of Pediatric Surgery Department
Russian Federation, Moscow; MoscowVasiliy S. Shumikhin
Pirogov Russian National Research Medical University; Filatov Children’s Hospital
Email: pennylane@yandex.ru
ORCID iD: 0000-0001-9477-8785
SPIN-code: 6405-8928
Cand. Sci. (Med.), Head of Neonatal Surgery Department, Assistant Professor of Pediatric Surgery Department
Russian Federation, Moscow; MoscowSvetlana V. Smirnova
Pirogov Russian National Research Medical University; Filatov Children’s Hospital
Email: swsmirnova@gmail.com
ORCID iD: 0000-0001-9158-4571
SPIN-code: 8996-7065
Cand. Sci. (Med.), Surgeon of Neonatal Surgery Department, Assistent professor of Pediatric Surgery Department
Russian Federation, Moscow; MoscowElena V. Zilbert
Pirogov Russian National Research Medical University; Filatov Children’s Hospital
Email: sotalol@mail.ru
ORCID iD: 0000-0003-4170-3733
Cand. Sci. (Med.), Head of the Department of Intensive Care Unit, Assistent Professor of Pediatric Surgery Department
Russian Federation, Moscow; MoscowLubov V. Petrova
Filatov Children’s Hospital
Email: celine1988@mail.ru
ORCID iD: 0000-0001-8727-5514
SPIN-code: 8928-4543
Surgeon of Neonatal Surgery Department
Russian Federation, MoscowNadezhda O. Erokhina
Pirogov Russian National Research Medical University; Filatov Children’s Hospital
Email: nadegdaerokhina@yandex.ru
ORCID iD: 0000-0003-0519-7220
SPIN-code: 5169-3443
Pediatric Surgery of the Neonatal Department
Russian Federation, Moscow; MoscowRashid V. Halafov
Pirogov Russian National Research Medical University; Filatov Children’s Hospital
Email: drrash777@gmail.com
ORCID iD: 0000-0001-7998-5639
SPIN-code: 7141-9649
Cand. Sci. (Med.), Surgeon of Neonatal Surgery Department, Assistant professor of Pediatric Surgery Department
Russian Federation, Moscow; MoscowTatyana O. Svetlichnaya
Filatov Children’s Hospital
Email: pyera@ya.ru
ORCID iD: 0000-0001-7074-664X
Physician of Intensive Care Unit
Russian Federation, MoscowReferences
- Alghamdi A, Raboe E. Right Bochdalek congenital diaphragmatic hernia: a tertiary center’s experience over 13 years. Ann Pediatr Surg. 2021;17(1):24. doi: 10.1186/s43159-021-00081-z
- Aihole JS. Congenital right diaphragmatic defects: Our institutional experience. Afr J Paediatr Surg. 2021;18(3):133–138. doi: 10.4103/ajps.AJPS_29_20
- Ovsyannikov PA, Kosovtsova NV, Ryabokon NR, et al. Congenital diaphragmatic hernia. A systematic analysis. Journal of Obstetrics and Women’s Diseases. 2022;71(2):101–112. (In Russ.) doi: 10.17816/JOWD88926
- Chukanov AN. Prenatal prediction of outcomes in congenital diaphragmatic hernia based on fetal 3D/4D ultrasound lung morphometry and histogram analysis (a pilot study). Ultrasound and Functional Diagnostics. 2022;(1):19–26 (In Russ.) doi: 10.24835/1607-0771-2022-1-19-26
- Syrkashev EM, Solopova AE, Bychenko VG, et al. Predicting outcomes of congenital diaphragmatic hernia by calculating liver herniation derives. Neonatology: News, Opinions, Training. 2021;9(1):24–29. (In Russ.) doi: 10.33029/2308-2402-2021-9-1-24-29
- Rafat N, Schaible T. Extracorporeal membrane oxygenation in congenital diaphragmatic hernia. Front Pediatr. 2019;7:336. doi: 10.3389/fped.2019.00336
- Lapshin VI, Razin MP, Akselrov MA, et al. Toracoscopic treatment of the newborn infant with false right sided diaphragm hernia. Russian Journal of Pediatric Surgery. 2019;23(2):106–109. (In Russ.) doi: 10.18821/1560-9510-2019-23-2-106-109
- Lovskaya II, Chepurnoy MG, Chepurnoy GI, et al. An actual methods of right-sided congenital diaphragmatic hernias surgical treatment. Medical Herald of The South of Russia. 2014;(3):117–120. (In Russ.)
- Burgos CM, Frenckner B, Luco V, et al. Right versus left congenital diaphragmatic hernia — What’s the difference? J Pediatr Surg. 2017;53(1)113–117. doi: 10.1016/j.jpedsurg.2017.10.027
- Russo FM, Cordier AG, Basurto D, et al. Fetal endoscopic tracheal occlusion reverses the natural history of right-sided congenital diaphragmatic hernia: European multicenter experience. Ultrasound Obstet Gynecol. 2021;57(3):378–385. doi: 10.1002/uog.23115
- Schaible T, Kohl T, Reinshagen K, et al. Right- versus left-sided congenital diaphragmatic hernia: postnatal outcome at a specialized tertiary care center. Pediatr Crit Care Med. 2012;13(1):66–71. doi: 10.1097/PCC.0b013e3182192aa9
- Jeong J, Lee BS, Cha T, et al. Prenatal prognostic factors for isolated right congenital diaphragmatic hernia: a single center’s experience. BMC Pediatr. 2021;21(1):460. doi: 10.1186/s12887-021-02931-6
- Abramov A, Fan W, Hernan R, et al. Comparative outcomes of right versus left congenital diaphragmatic hernia: A multicenter analysis. J Pediatr Surg. 2020;55(1):33–38. doi: 10.1016/j.jpedsurg.2019.09.046
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