One-year outcomes of congenital diaphragmatic hernia repair: Factors associated with recurrence and complications

Alessia C. Cioci, Eva M. Urrechaga, Joshua Parreco, Lindsay F. Remer, Maiya Cowan, Eduardo A. Perez, Juan E. Sola, Chad M. Thorson

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: Congenital diaphragmatic hernia (CDH) is a congenital anomaly associated with lifelong multisystem morbidity. This study sought to identify factors contributing to hospital readmission after CDH repair. Methods: The Nationwide Readmissions Database from 2010 to 2014 was used to identify patients with CDH who underwent surgical repair. Primary outcomes included all cause readmission at 30-days and 1 year and readmission for hernia recurrence. Patient and hospital factors were compared using chi-squared analysis. Results: Five hundred eleven patients were identified with neonatal CDH. All repairs were performed at teaching hospitals via laparotomy in 59% (n = 303), thoracotomy in 36% (n = 183), and minimally invasive (MIS) repair in 5% (n = 25). The readmission rate within 30-days was 32% (n = 163), and 97% (n = 495) within 1 year. The most common conditions surrounding readmission were for gastroesophageal reflux (20%), CDH recurrence (17%), and surgery for gastrostomy tube and/or fundoplication (16%). Recurrence was significantly higher after MIS repair (48%) compared to those with open repair via either approach (16%), p < 0.001. Conclusions: This is the first study to evaluate nationwide readmissions in newborns with CDH. Readmission is commonly due to CDH recurrence and reflux-associated complications. The recurrence rate is higher than previously reported and is more common after MIS and repair via thoracotomy. Level of evidence: Level III treatment study.

Original languageEnglish (US)
Pages (from-to)1542-1546
Number of pages5
JournalJournal of Pediatric Surgery
Volume56
Issue number9
DOIs
StatePublished - Sep 2021

Keywords

  • Congenital diaphragmatic hernia
  • Hernia recurrence
  • Minimally invasive surgery

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Surgery

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