Long-Term Outcomes of Congenital Diaphragmatic Hernia: Report of a Multicenter Study in Japan
Masaya Yamoto,
Kouji Nagata,
Keita Terui,
Masahiro Hayakawa,
Hiroomi Okuyama,
Shoichiro Amari,
Akiko Yokoi,
Kouji Masumoto,
Tadaharu Okazaki,
Noboru Inamura,
Katsuaki Toyoshima,
Yuhki Koike,
Yuta Yazaki,
Taizo Furukawa,
Noriaki Usui
Affiliations
Masaya Yamoto
Department of Pediatric Surgery, Shizuoka Children’s Hospital, Shizuoka 420-8660, Japan
Kouji Nagata
Department of Pediatric Surgery, Reproductive and Developmental Medicine, Faculty of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-Ku, Fukuoka 812-8582, Japan
Keita Terui
Department of Pediatric Surgery, Chiba University Graduate School of Medicine, Chiba 260-867, Japan
Masahiro Hayakawa
Division of Neonatology, Center for Maternal-Neonatal Care, Nagoya University Hospital, Nagoya 466-8560, Japan
Hiroomi Okuyama
Department of Pediatric Surgery, Osaka University Graduate School of Medicine, Osaka 565-0871, Japan
Shoichiro Amari
Division of Neonatology, National Center for Child Health and Development, Tokyo 157-0074, Japan
Akiko Yokoi
Department of Pediatric Surgery, Kobe Children’s Hospital, Kobe 650-0047, Japan
Kouji Masumoto
Department of Pediatric Surgery, Tsukuba University, Tsukuba 305-8577, Japan
Tadaharu Okazaki
Department of Pediatric Surgery, Juntendo University Urayasu Hospital, Urayasu 279-0021, Japan
Noboru Inamura
Department of Pediatrics, Kindai University Faculty of Medicine, Osaka-Sayama 589-0014, Japan
Katsuaki Toyoshima
Department of Neonatology, Kanagawa Children’s Medical Center, Yokohama 232-8555, Japan
Yuhki Koike
Department of Gastrointestinal and Pediatric Surgery, Mie University Graduate School of Medicine, Tsu 514-8507, Japan
Yuta Yazaki
Department of Pediatric General and Urogenital Surgery, Juntendo University School of Medicine, Tokyo 113-8421, Japan
Taizo Furukawa
Department of Pediatric Surgery, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan
Noriaki Usui
Department of Pediatric Surgery, Osaka Women’s and Children’s Hospital, Izumi 594-1101, Japan
Background: Treatment modalities for neonates with congenital diaphragmatic hernia (CDH) have greatly improved in recent years, with a concomitant increase in survival. However, long-term outcomes restrict the identification of optimal care pathways for CDH survivors in adolescence and adulthood. Therefore, we evaluated the long-term outcomes within the Japanese CDH Study Group (JCDHSG). Methods: Participants were born with CDH between 2006 and 2018 according to the JCDHSG. Participants were enrolled in the database at 1.5, 3, 6, and 12 years old. Follow-up items included long-term complications, operations for long-term complication, and home medical care. Results: A total of 747 patients were included in this study, with 626 survivors (83.8%) and 121 non-survivors (16.2%). At 1.5, 3, 6, and 12 years old, 45.4%, 36.5%, 34.8%, and 43.6% developed complications, and 20.1%, 14.7%, 11.5%, and 5.1% of participants required home care, respectively. Recurrence, pneumonia, pneumothorax, gastroesophageal reflux disease, and intestinal obstruction decreased with age, and thoracic deformity increased with age. Conclusions: As CDH survival rates improve, there is a need for continued research and fine-tuning of long-term care to optimize appropriate surveillance and long-term follow-up.
