Our Summary

This study investigates the best time to perform surgery on babies born with a hole in their diaphragm (a condition known as congenital diaphragmatic hernia, or CDH). Specifically, the researchers were interested in when to perform this surgery after the baby has been put on a life-support machine that does the work of the heart and lungs (known as extracorporeal membrane oxygenation, or ECMO).

The researchers used data from a large registry of CDH patients between 2007 and 2017. They compared the outcomes of babies who had surgery while still on the ECMO machine (On ECMO group) versus those who had surgery after being removed from the machine (After ECMO group). They also compared the outcomes of babies who had surgery early after being put on ECMO versus those who had surgery later.

The study found that babies in the On ECMO group and those who had early surgery had lower death rates and were less likely to not have the surgery at all. This suggests that performing the surgery early after ECMO cannulation can improve survival rates.

FAQs

  1. What is the best time to perform surgery on babies with congenital diaphragmatic hernia (CDH) according to this study?
  2. What were the outcomes of the CDH patients who had surgery while still on the ECMO machine compared to those who had surgery after being removed from the machine?
  3. Does performing surgery early after ECMO cannulation improve survival rates for babies with CDH?

Doctor’s Tip

A doctor might advise a patient that early surgery for congenital diaphragmatic hernia repair, especially while the baby is still on ECMO, may lead to better outcomes and improved survival rates. It is important to discuss the timing of surgery with your medical team to determine the best course of action for your baby’s specific situation.

Suitable For

Patients with congenital diaphragmatic hernia who are recommended for repair typically include those who require ECMO support and those who are stable enough to undergo surgery. The study suggests that performing surgery early after ECMO cannulation can improve survival rates in these patients.

Timeline

Before congenital diaphragmatic hernia repair:

  • Baby is diagnosed with congenital diaphragmatic hernia
  • Baby may be placed on extracorporeal membrane oxygenation (ECMO) machine to support heart and lung function
  • Doctors monitor baby’s condition and determine the optimal timing for surgery

After congenital diaphragmatic hernia repair:

  • Surgery is performed to repair the hole in the diaphragm
  • Baby is monitored closely post-surgery for any complications
  • Recovery and rehabilitation process begins
  • Long-term follow-up care is provided to monitor the baby’s health and development

What to Ask Your Doctor

  1. What is congenital diaphragmatic hernia and why does my baby need surgery for it?
  2. What are the risks and benefits of surgery for congenital diaphragmatic hernia?
  3. What is the success rate of surgery for congenital diaphragmatic hernia?
  4. What is the best timing for surgery in relation to being on ECMO?
  5. How will the surgery be performed and what is the recovery process like?
  6. What are the potential long-term effects or complications of surgery for congenital diaphragmatic hernia?
  7. Are there any alternative treatment options or approaches for congenital diaphragmatic hernia?
  8. What is the expected outcome for my baby after surgery?
  9. How will my baby’s care be managed following surgery for congenital diaphragmatic hernia?
  10. Are there any lifestyle changes or precautions I should take after my baby has surgery for congenital diaphragmatic hernia?

Reference

Authors: Dao DT, Burgos CM, Harting MT, Lally KP, Lally PA, Nguyen HT, Wilson JM, Buchmiller TL. Journal: Ann Surg. 2021 Jul 1;274(1):186-194. doi: 10.1097/SLA.0000000000003386. PMID: 31425289