Our Summary

This research paper looks at whether operating sooner on infants with a certain kind of hernia (congenital diaphragmatic hernia) who are on a specific type of life-support (extracorporeal membrane oxygenation) leads to better results. This is compared to those who have the operation a bit later (within 72 hours). The study found that the survival rate was slightly higher for those who had the operation within 24 hours (71.4%) than those who had it later (59.7%). However, there was no significant difference in disease severity or the length of hospital stay, time on ventilator, or time on life-support between the two groups. The researchers concluded that operating sooner may not be harmful and may have similar outcomes as operating later. However, more research needs to be done to confirm these findings.

FAQs

  1. Does operating sooner on infants with congenital diaphragmatic hernia result in better survival rates?
  2. Is there any significant difference in disease severity or the length of hospital stay between infants who have the operation within 24 hours and those who have it later?
  3. What conclusions did the researchers draw about the timing of surgery for infants with congenital diaphragmatic hernia who are on life-support?

Doctor’s Tip

A doctor may advise a patient that early surgical repair of congenital diaphragmatic hernia may lead to slightly better survival rates, but timing may not significantly impact other outcomes such as disease severity or length of hospital stay. It is important to discuss the potential benefits and risks of early surgery with your healthcare provider to determine the best course of action for your individual situation.

Suitable For

Patients with congenital diaphragmatic hernia are typically recommended for repair surgery, especially if they are experiencing severe symptoms or complications such as respiratory distress, gastrointestinal issues, or failure to thrive. The decision to recommend surgery is based on the individual patient’s condition, overall health, and the severity of the hernia. In some cases, surgery may be recommended immediately after birth or within the first few days of life to prevent further complications and improve outcomes. It is important for patients with congenital diaphragmatic hernia to be evaluated by a multidisciplinary team of healthcare providers, including pediatric surgeons, neonatologists, and respiratory therapists, to determine the best course of treatment for their specific needs.

Timeline

Before congenital diaphragmatic hernia repair:

  • Patient is diagnosed with congenital diaphragmatic hernia through prenatal ultrasound or after birth
  • Patient may experience respiratory distress, difficulty breathing, and other symptoms related to the hernia
  • Patient may be placed on extracorporeal membrane oxygenation (ECMO) for life-support
  • Patient undergoes evaluation and preparation for surgery

After congenital diaphragmatic hernia repair:

  • Patient undergoes surgery to repair the hernia, which involves closing the hole in the diaphragm and possibly repositioning abdominal organs
  • Patient is closely monitored in the intensive care unit post-surgery for complications and recovery
  • Patient may require continued respiratory support through a ventilator
  • Patient may spend an extended period of time in the hospital for recovery and rehabilitation
  • Patient undergoes follow-up appointments and monitoring to ensure successful healing and recovery from the surgery

What to Ask Your Doctor

  1. What is congenital diaphragmatic hernia and how does it affect my child’s health?
  2. What are the treatment options for congenital diaphragmatic hernia repair?
  3. What are the risks and benefits of operating on my child within 24 hours compared to operating within 72 hours?
  4. How will the timing of the surgery impact my child’s recovery and long-term outcomes?
  5. What are the potential complications associated with congenital diaphragmatic hernia repair surgery?
  6. What is the success rate of the surgery for infants with congenital diaphragmatic hernia?
  7. What is the expected recovery time for my child after the surgery?
  8. Will my child need ongoing medical care or monitoring after the surgery?
  9. Are there any specific precautions or lifestyle changes my child will need to follow post-surgery?
  10. Are there any alternative treatments or therapies that may be beneficial for my child’s condition?

Reference

Authors: Steen EH, Lee TC, Vogel AM, Fallon SC, Fernandes CJ, Style CC, Verla MA, Balaji S, Olutoye OO, Keswani SG. Journal: J Pediatr Surg. 2019 Jan;54(1):50-54. doi: 10.1016/j.jpedsurg.2018.10.038. Epub 2018 Oct 5. PMID: 30482539