共查询到20条相似文献，搜索用时 31 毫秒
1.
Nicola Disma Davinia Withington Mary Ellen McCann Rodney Wayne Hunt Sarah Jane Arnup Francesca Izzo Jurgen C. de Graaff Girolamo Mattioli Neil Morton Geoff Frawley Andrew Davidson Anne Lynn Peter Szmuk Joss John Thomas Philip Ragg Alessio Pini Prato 《Journal of pediatric surgery》2018,53(9):1643-1650
2.
Suolin Li Xuelai Liu Kenneth K.Y. Wong Lin Liu Yingchao Li 《Journal of pediatric surgery》2018,53(12):2507-2510
Background
Laparoscopic percutaneous extraperitoneal closure (LPEC) with variable devices seems to be one of the most simple and reliable methods. We described our modifications of single-port laparoscopic herniorrhaphy using an inner two-hooked cannula device with preperitoneal hydrodissection.Patients and methods
1568 children with 2114 inguinal hernias were treated by single-port LPEC. Under laparoscopic visualization, the two-hooked cannula device carrying a silk suture was inserted at the point of the internal ring and could be readily kept in an identical path. The hernia orifice was completely lassoed extraperitoneally by the suture with the assistance of hydrodissection. Any huge hernias of more than 1.5?cm were repaired with the incorporation of medial umbilical fold flap as reinforcement.Results
All hernia repairs were successfully performed by LPEC. 1022 patients had unilateral inguinal hernia repair, and 546 patients underwent bilateral inguinal hernia repair. Of these, additional medial umbilical flap reinforcement was necessary in 68 cases, and an assisted grasping instrument was used in 19 cases owing to omental adhesion or sliding hernia. Mean operating times for unilateral and bilateral inguinal hernia repairs were 9.8?±?2.1?min and 13.6?±?2.2?min, respectively. There were no operative complications. Two recurrences and three hydroceles were observed during 6 to 30?months of follow-up.Conclusions
One-puncture LPEC using the two-hooked cannula device with preperitoneal hydrodissection has proved to be a safe and effective procedure with excellent cosmetic results.Level of evidence
IV 相似文献3.
Brian C Gulack Rachel Greenberg Reese H Clark Marie Lynn Miranda Martin L Blakely Henry E Rice Obinna O Adibe Elisabeth T Tracy P Brian Smith 《Journal of pediatric surgery》2018,53(4):784-788
Purpose
Inguinal hernias are common in premature infants, but there is substantial variation with regards to timing of repair. We sought to quantify and explain this variation.Methods
Cohort study of infants < 34 weeks gestation diagnosed with an inguinal hernia and discharged from one of 329 neonatal intensive units between 1998 and 2012. Multivariable logistic regression clustered by site was used to evaluate demographic, clinical, maternal, and socioeconomic variables associated with pre-discharge repair.Results
A total of 8037 infants met study criteria, and 3230 (40%) received a pre-discharge repair. The frequency of pre-discharge repair varied by site from 9% to 84%, and increased over the study period from 20% in 1998 to 45% in 2012. Concurrent gastrostomy or fundoplication and lower socioeconomic status were associated with an increased odds of receiving a pre-discharge repair.Conclusion
There is substantial variation with regards to the timing of repair of inguinal hernias in premature infants, with an increasing number of infants receiving repair prior to hospital discharge over time. Concurrent gastrostomy or fundoplication and socioeconomic status are associated with timing of repair.Level of evidence
IV. 相似文献4.
Jin K. Kim Michael E. Chua Jessica M. Ming Joana Dos Santos Elke Zani-Ruttenstock Alanna Marson Mark Bayley Martin A. Koyle 《Journal of pediatric surgery》2018,53(10):2041-2047
Background/purpose
Limited efforts have been made in assessing the qualities of clinical practice guidelines (CPGs) on cryptorchidism (UDT). This appraisal aims to determine the quality of recent CPGs on the management of UDT.Methods
After systematic literature search, all English-based CPGs providing recommendations for the management of UDT from 2012 to 2017 were reviewed. Using the AGREE II (Appraisal of Guidelines and Research Evaluation) instrument, eligible CPGs were independently appraised by 5 reviewers. Domain scores were calculated and summarized. Intraclass coefficient (ICC) was used to assess for interrater reliability.Results
Five CPGs from Agency for Healthcare Research and Quality (AHRQ), American Urological Association (AUA), British Association of Pediatric Surgeons/British Association of Urologic Surgeons (BAPS/BAUS), Canadian Urological Association (CUA), and European Association of Urology/European Society for Pediatric Urology (EAU/ESPU) were assessed. There was a solid agreement (ICC: 0.749) among the 5 reviewers (p < 0.001). Most recommendations for diagnostic and treatment approaches were consistent across CPGs. For most guidelines, the domains of ‘clarity of presentation,’ ‘scope and purpose,’ ‘stakeholder involvement,’ and ‘rigor of development’ were high, while ‘applicability’ was low.Conclusion
Most guidelines on UDT score high in the AGREE II domains and have consistent recommendations. To improve the ‘applicability’ domain, future guidelines should improve on aspects that facilitate implementation of the recommendations.Type of study
Systematic review.Level of evidence
V (based on the lowest level of evidence utilized by the assessed guidelines). 相似文献5.
Verena Ellerkamp Andreas Schmid Gunnar Blumenstock Georg Hrivatakis Wolfgang Astfalk Steffan Loff Joerg Fuchs Sabine Zundel 《Journal of pediatric surgery》2018,53(11):2219-2224
Background
Early orchidopexy (OP) around the age of 1 year is recommended in boys with congenital undescended testis (UDT) worldwide since decades. Former retrospectives studies did not distinguish congenital from acquired UDT with a consecutive negative bias concerning the age at surgery.Methods
In a retrospective analysis, data of all boys who underwent OP in eight pediatric surgery institutions from 2009 to 2015 were analyzed. Congenital or acquired UDT were differentiated. Patients were categorized into 3 groups of age at surgery: (1) < 12?months, (2) 12–24?months, (3) > 24?months. Data of one institution were analyzed in detail: exact age of first referral, exact age at surgery, intraoperative findings.Results
Out of 4448 boys, 3270 boys had congenital UDT. In 81% (2656 cases) surgery was performed beyond the age of 1 year, in 54.4% (1780) beyond the age of 2 years. chi-Square statistics showed a higher rate of early operations in hospitals compared to outpatient services and in Germany compared to Switzerland. In 694 congenital detailed cases, median age at referral was 13?months [range 0–196], median age at surgery was 15?months [range 0–202].Conclusion
Delayed referral is the main reason for guideline non-conform delayed surgery in UDT.Type of Study
Clinical Research paper.Level of evidence
Level III: Treatment Study. 相似文献6.
Carmen Mesas Burgos Marcus G. Davey John S. Riley Huimin Jia Alan W. Flake William H. Peranteau 《Journal of pediatric surgery》2018,53(9):1681-1687
Background
Lung and pulmonary vascular maldevelopment in congenital diaphragmatic hernia (CDH) results in significant morbidity and mortality. Retinoic acid (RA) and imatinib have been shown to improve pulmonary morphology following prenatal administration in the rat nitrofen-induced CDH model. It remains unclear if these changes translate into improved function. We evaluated the effect of prenatal RA and imatinib on postnatal lung function, structure, and pulmonary artery (PA) blood flow in the rat CDH model.Methods
Olive oil or nitrofen was administered alone or in combination with RA or imatinib to pregnant rats. Pups were assessed for PA blood flow by ultrasound and pulmonary function/morphology following delivery, intubation, and short-term ventilation.Results
Neither RA nor imatinib had a negative effect on lung and body growth. RA accelerated lung maturation indicated by increased alveoli number and thinner interalveolar septa and was associated with decreased PA resistance and improved oxygenation. With the exception of a decreased PA pulsatility index, no significant changes in morphology and pulmonary function were noted following imatinib.Conclusion
Prenatal treatment with RA but not imatinib was associated with improved pulmonary morphology and function, and decreased pulmonary vascular resistance. This study highlights the potential of prenatal pharmacologic therapies, such as RA, for management of CDH. 相似文献7.
In Geol Ho Kyong Ihn Eun-Jung Koo Eun Young Chang Jung-Tak Oh 《Journal of pediatric surgery》2018,53(10):2008-2012
Purpose
This study aimed to evaluate the usefulness of laparoscopic repair of inguinal hernia (LR) in infants in comparison with open hernia repair (OR).Methods
We retrospectively analyzed the clinical data of 465 infants treated for inguinal hernia from January 2006 to December 2015. Among them, 124 underwent LR and 341 underwent OR.Results
In the OR group, 16.1% (55/341) primarily underwent bilateral inguinal hernia repair and 13.6% (42/308) subsequently developed metachronous contralateral inguinal hernia during follow-up. In the LR group, 75.8% (94/124) underwent primary bilateral inguinal hernia repair and only 1.6% (2/123) developed metachronous contralateral inguinal hernia. The mean operation times of unilateral inguinal hernia repair showed no statistical differences between LR and OR. However, the mean operation times of bilateral inguinal hernia repair were shorter in LR (39.8 ± 10.4 vs. 51.1 ± 14.4 min, p < 0.001). Postoperative recurrence and wound infection showed no statistical differences between the groups, but postoperative scrotal swelling was more common in OR (0.0% vs. 4.0%, p = 0.006).Conclusion
LR in infants showed a lower incidence of metachronous hernia, shorter operation times, and better postoperative course than OR. LR could be considered the primary operation method in infants with inguinal hernia.Levels of Evidence
Prognosis Study, Retrospective Study, Level III. 相似文献8.
Ali Kamran Benjamin Zendejas Farokh R. Demehri Bharath Nath David Zurakowski Charles J. Smithers 《Journal of pediatric surgery》2018,53(11):2087-2091
Purpose
To identify technical modifications concerning factors that may lower the risk of recurrence following thoracoscopic repair of congenital diaphragmatic hernia (CDH).Methods
All CDH patients who underwent thoracoscopic repair from April 2003 to September 2017 were retrospectively reviewed. Some of the more recently treated patients underwent technically modified repairs with underlay and overlay buttresses.Results
Sixty-eight patients underwent thoracoscopic repair of a diaphragmatic hernia that presented either neonatally (n?=?52) or beyond the neonatal period (> 1?month) (n?=?16). At our institution, the minimally invasive surgical approach is considered for clinically stable CDH patients, who are likely to have type A or B defects. 21 patients had a sac-type defect. Forty-seven patients with type A defect had primary closure, buttressed in 6 cases. In 21 patients, the type B defect was repaired with a patch, buttressed in 11 patients. Median follow-up was 36?months (IQR 9–45). Recurrence occurred in 13 patients (overall 19% recurrence rate); all had a neonatally presented defect (25% vs. 0%, p?=?0.03). Patients with a sac-type defect had a lower recurrence rate than patients with no hernia sac (5% vs. 26%, p?=?0.05). Recurrence complicated 7 of 47 (15%) patients after primary closure and 6 of 21 (29%) patients with patch repair; none of the 17 cases with buttressed repairs had a recurrence.Conclusions
Due to a higher rate of recurrence following thoracoscopic CDH repair compared to the standard open approach, we suggest a sandwich-type buttress repair with underlay and overlay components for both primary and patch repairs.Level of Evidence
Level III cohort study. 相似文献9.
10.
Loren Berman Jordan Jackson Kristen Miller Rebecca Kowalski Paul Kolm Francois I. Luks 《Journal of pediatric surgery》2018,53(8):1592-1599
Background
Pediatric surgeons frequently offer prenatal consultation for congenital pulmonary airway malformation (CPAM) and congenital diaphragmatic hernia (CDH); however, there is no evidence-based consensus to guide prenatal decision making and counseling for these conditions. Eliciting feedback from experts is integral to defining best practice regarding prenatal counseling and intervention.Methods
A Delphi consensus process was undertaken using a panel of pediatric surgeons identified as experts in fetal therapy to address current limitations. Areas of discrepancy in the literature on CPAM and CDH were identified and used to generate a list of content and intervention questions. Experts were invited to participate in an online Delphi survey. Items that did not reach first-round consensus were broken down into additional questions, and consensus was achieved in the second round.Results
Fifty-four surgeons (69%) responded to at least one of the two survey rounds. During round one, consensus was reached on 54 of 89 survey questions (61%), and 45 new questions were developed. During round two, consensus was reached on 53 of 60 survey questions (88%).Conclusions
We determined expert consensus to establish guidelines regarding perinatal management of CPAM and CDH. Our results can help educate pediatric surgeons participating in perinatal care of these patients.Level of Evidence
V. 相似文献11.
Masahiro Zenitani Takashi Sasaki Natsumi Tanaka Takaharu Oue 《Journal of pediatric surgery》2018,53(7):1288-1294
Background/purpose
We evaluated the long-term umbilical appearance and patient/parent satisfaction at follow-up after umbilical hernia repair (UHR).Methods
In a retrospective review of 128 children who underwent UHR and were followed up for over 5 years, satisfaction was assessed using e-mailed questionnaires and attached photographs of the umbilicus.Results
The survey response rate was 80.3% by parents, 79.5% by patients, and 72.1% using photographs. The median follow-up period was 7.6 (range, 5.3–10.1) years. The satisfaction rate was 78.9% among parents and 91.5% among patients; however, eight patients (8.5%) reported dissatisfaction with the results. The main reason for dissatisfaction was the shallow depth of the umbilicus (parents, 10/20; patients, 5/8). During the follow-up period, satisfaction increased in 14 cases (14.7%) and decreased in 10 cases (10.5%). Superior hooding was considered an ideal shape for the umbilicus. Concomitant laparoscopic surgery and higher age at surgery were significantly associated with dissatisfaction in parents (P = 0.045) and patients (P = 0.046), respectively. Large defect size was significantly associated with decreased satisfaction during the follow-up period (P = 0.030).Conclusion
E-mail surveys are useful for long-term follow-up after UHR. Patients with these above risk factors should receive long-term follow-up with careful attention to patient satisfaction.Level of evidence
Type of study: prognosis study, level II. 相似文献12.
Arnab Majumder Sean B. Orenstein Heidi J. Miller Yuri W. Novitsky 《American journal of surgery》2018,215(1):82-87
Background
Parastomal hernia repair (PHR) remains a challenge with no optimal repair technique. During retromuscular hernia repair, traversing the stomal conduit through the abdominal wall can result in angulation and compression. Widening of traditional cruciate incisions in mesh and/or fascia likely contributes to recurrences. To address these pitfalls, the Stapled Transabdominal Ostomy Reinforcement with Retromuscular Mesh (STORRM) technique utilizing a circular stapler was developed.Methods
A prospective registry of consecutive patients undergoing STORRM was analyzed. We characterized demographics, hernia characteristics, and perioperative results. Primary outcomes were complications, surgical site events (SSEs) and hernia recurrence.Results
12 patients underwent PHR with STORRM; mean age 64 and BMI 36 kg/m2. Synthetic mesh was used in 92% of patients. We observed two (17%) SSEs, one case of cellulitis and one organ space infection. With mean 12.8-month follow-up, we documented two recurrences.Conclusions
STORRM represents a safe method to repair parastomal hernias. The unified aperture with stapled reinforcement results in reproducible repairs, minimizing intestinal angulation associated with traditional stoma passage. Early outcomes evidenced minimal complications and favorable recurrence rate. 相似文献13.
Carmen Mesas Burgos Björn Frenckner Matias Luco Matthew T. Harting Pamela A. Lally Kevin P. Lally 《Journal of pediatric surgery》2018,53(1):113-117
Background
Right-sided congenital diaphragmatic hernias (CDH) and bigger defect sizes have been associated with poorer outcomes.Aim
The aim of this study was to evaluate right- and left-sided CDH in terms of size, survival, associated anomalies, and morbidity.Material and methods
We used information from a multicenter, multinational database including patients with CDH born between 2007 and 2015. All infants with data on defect side were included for this analysis. We compared differences in outcomes between right- and left-sided CDH. Further analysis on the association between side, size of the defect, and outcome was performed.Results
A total of 3754 cases of CDH were entered in the registry between January 2007 and September 2015, with an overall survival of 71%. Of those, 598 (16%) were right-sided and 3156 left-sided, with a survival rate of 67% and 72%, respectively. Right-sided CDH had a larger proportion of C and D defects (p < 0.001 and 0.04, respectively). Survival rates for the same size defect were similar, independent of the side of the defect. Multivariable logistic regression analysis with survival as dependent variable identified a significant correlation with defect size, but not side.Conclusions
The higher proportion of large defects (C & D) in right-sided CDH, not the side itself, accounts for the reported poorer survival in right-sided CDH.Level of evidence
Level I for a prognosis study – This is a high-quality, prospective cohort study with 99% of patients followed to the study end point (death or discharge). 相似文献14.
Joseph T. Church Rodrigo Mon Tiffany Wright Megan A. Coughlin Maria Ladino-Torres Christopher Tapley Heather Bowen Niki Matusko George B. Mychaliska 《Journal of pediatric surgery》2018,53(6):1087-1091
Purpose
Survivors of congenital diaphragmatic hernia (CDH) face high morbidity. We studied the neurodevelopmental outcomes of CDH survivors at a single institution.Methods
CDH survivors born July 2006–March 2016 at a free-standing children's hospital were reviewed. Neurodevelopment was assessed using the Peabody Developmental Motor Scales (PDMS-2) broken into gross, fine, and total motor quotients. Data collected included prenatal variables (liver herniation, defect laterality, observed:expected total fetal lung volume (o:eTFLV) on MRI), birth demographics (sex, race, estimated gestational age (EGA), birth weight (BtWt), 5 min APGAR, associated anomalies), and therapies/hospital course (HFOV/HFJV, ECMO, timing of repair, pulmonary hypertension (PHTN) severity, length of stay, ventilator days). Variables were analyzed using mixed linear modeling.Results
Sixty-eight children were included. Most patients had left-sided CDH (55/68, 81%) without liver herniation (42/68, 62%). ECMO utilization was 25/68 (37%). The mean [95% confidence interval] gross motor quotient for the entire cohort was 87 [84–91], fine motor quotient was 92 [88–96], and total motor quotient was 88 [84–93], representing below average, average, and below average functioning, respectively. o:eTFLV predicted fine motor quotient among prenatal variables. Associated anomalies and ECMO use predicted all quotients in the final model.Conclusions
Associated anomalies and ECMO use predict neurodevelopmental delay in CDH survivors.Type of Study
Retrospective observational study; Prognostic.Level of Evidence
II. 相似文献15.
Purpose
Spigelian hernias in childhood are rare. Only 24 infants in the English literature have been identified to have spigelian hernias, and 12 of these have been associated with cryptorchidism. Spigelian hernias are more commonly seen in the adult population and are considered to be acquired because they are typically associated with trauma or other etiologies of increased intraabdominal pressure. In the infant however, the etiology remains unclear, but a congenital defect in abdominal wall development is suspected.Methods
We discuss the presentation and treatment of 4 additional patients with spigelian hernias (2 siblings included) associated with cryptorchidism.Results
The hernias occurred within the well-described spigelian hernia belt in the semilunar line at the level of the semicircular fold of Douglas. Of the 6 repaired spigelian hernias, 5 were closed primarily with absorbable suture similar to previously reported cases; the sixth hernia required a patch closure because of its large size. All cryptorchid testes (7) were repaired in single-stage orchiopexies.Conclusions
Spigelian hernias are rare entities in infants. We present 4 new cases of spigelian hernias associated with cryptorchidism and, with previously reported cases, discuss the probability of a congenital origin of these hernias in infants. 相似文献16.
Kathryn Taylor Kristin A. Sonderman Lindsey L. Wolf Wei Jiang Lindsey B. Armstrong Tracey P. Koehlmoos Brent R. Weil Robert L. Ricca Christopher B. Weldon Adil H. Haider Samuel E. Rice-Townsend 《Journal of pediatric surgery》2018,53(11):2214-2218
Purpose
We aimed to describe the incidence, timing, and predictors of recurrence following inguinal hernia repair (IHR) in children.Methods
We used the TRICARE claims database, a national cohort of > 3 million child dependents of members of the U.S. Armed Forces. We abstracted data on children < 12y who underwent IHR (2005–2014). Our primary outcome was recurrence (ICD9-CM diagnosis codes). We calculated incidence rates for the population and stratified by age, time from repair to recurrence, and multivariable logistic regression to determine predictors.Results
Nine thousand nine hundred ninety-three children met inclusion criteria. Age at time of IHR was ≤ 1y in 37%, 2-3y in 23%, 4–5y in 16%, and 5–12y in 24%. Median follow-up time was 3.5y (IQR:1.6–6.1). 137 patients recurred (1.4%), with an incidence of 3.46 per 1000 person-years. Over half occurred in children 0-1y at repair (60%). The majority occurred within a year following repair (median 209?days [IQR:79–486]). Children 0-1y had 2.53 times greater odds of recurrence (compared to > 5y). Children with multiple comorbidities had 5.45 times greater odds compared to those with no comorbidities.Conclusions
The incidence of recurrence following IHR is 3.46 per 1000 person-years. The majority occurred within a year of repair. Children ≤ 1y and those with multiple comorbidities were at increased risk.Level of Evidence
Prognosis Study, Level II. 相似文献17.
Kibileri Williams Lauren Baumann Adil Shah Fizan Abdullah Emilie K. Johnson Tolulope A. Oyetunji 《Journal of pediatric surgery》2018,53(1):86-89
Purpose
Undescended testis (UDT) is the most common congenital anomaly of the male genitalia. The American Urological Association guidelines recommend orchiopexy by age 18 months to ameliorate the risk of subfertility. The study aim was to assess adherence to these guidelines on a national level.Methods
We retrospectively reviewed both the State Ambulatory Surgery Database (SASD) in 2012 and the Pediatric Health Information System (PHIS) for 2015. All patients aged 18 years or less with a diagnosis of UDT who underwent orchiopexy were included. Demographic data including age at repair as well as surgical subspecialty and payer status were extracted.Results
Analysis of the 2012 SASD for New Jersey, Florida, and Maryland yielded 1654 patients. The majority were white, 791 (48.3%), with a median age at repair of 4 years (IQR 1–8). Most patients, 1048 (64%), had orchiopexy later than age 2. A total of 844 males were identified from the PHIS database. Of these, 63% were white. The median age at repair was 5 years (IQR 1–9). There were 577 (68%) patients older than 2 years at orchiopexy.Conclusion
Almost 70% of boys with undescended testes in the United States are undergoing orchiopexy at least 6 months later than the recommended age.Type of study
Retrospective.Level of evidence
III. 相似文献18.
Saskia Silber Victoria Margaux Becker Rudolf Seufert Oliver J. Muensterer 《Journal of pediatric surgery》2019,54(1):177-183
Background/purpose
Inguinal hernia repair and orchidopexy are among the most common operations in boys. The impact on future fertility has not been conclusively defined. This study evaluates sperm quality after previous inguinal surgery.Methods
Spermiograms of men with a desire to conceive children were analyzed. History of previous inguinal surgery (hernia repair, orchidopexy, varicocele ligation) was correlated with sperm quality. Other influential factors (age, BMI, chronic medication, tobacco use) were also tested.Results
A total of 333 patients were included. Overall, 12.6% of the subjects had undergone previous inguinal surgery. Of these, 17 (43%) were inguinal hernia repairs, 8 (20%) orchidopexies, and 6 (15%) varicocele ligations, while 9 (22%) could not give an exact history. Abnormal spermiograms were found in 60% (n?=?24) of those with previous inguinal surgery versus 48% in controls (p?=?0.16). On multivariate analysis, pathologic spermiogram parameters were associated with previous inguinal surgery, orchidopexy, use of chronic medication, and smoking, but NOT with inguinal hernia or varicocele repair alone.Conclusions
Previous inguinal hernia or varicocele repair does not seem to impact negatively on quality of sperm later in life. Orchidopexy, smoking, and use of chronic medication, however, were all associated with pathologic sperm quality parameters.Type of study
Prospective comparative study.Level of evidence
Level II. 相似文献19.
Matthew Wong Janette Reyes Eveline Lapidus-Krol Monping Chiang Tilman Humpl Malikah Al-Faraj Greg Ryan Priscilla P.L. Chiu 《Journal of pediatric surgery》2018,53(5):918-924
Prenatal observed/expected lung–to-head ratio (O/E LHR) by ultrasound correlates with postnatal mortality for congenital diaphragmatic hernia (CDH) patients. The aim of this study is to determine if O/E LHR correlates with pulmonary hypertension (PH) outcomes for CDH patients.
Methods
A single center retrospective chart review was performed for CDH neonates from January 1, 2006, to December 31, 2015, (REB #1000053124) to include prenatal O/E LHR, liver position, first arterial blood gas, repair type, echocardiogram (ECHO), and lung perfusion scan (LPS) results up to 5 years of age.Results
Of 153 newborns, 123 survived (80.4%), 58 (37.9%) had prenatal O/E LHR, and 42 (27.5%) had postnatal ECHO results. High mortality risk neonates (O/E LHR ≤ 45%) correlated with higher right ventricular systolic pressure (RVsp) at birth. Generally PH resolved by age 5 years. LPS results did not change over time (p > 0.05) regardless of initial PH severity, suggesting that PH resolution did not correlate with increased ipsilateral lung perfusion to offload the right ventricle.Conclusion
Prenatal prognostic markers correlated with initial PH severity for CDH newborns, but PH resolved over time despite fixed perfusion bias to the lungs. These results suggest favorable PH outcomes for CDH patients who survive beyond infancy.Type of Study
Retrospective Cohort Study.Level of Evidence
3b 相似文献20.
Antonio Carlos Valezi Barbara Godinho Ferreira de Melo Antonio Cesar Marson Mario Liberatti Ascencio Garcia Lopes 《Surgery for obesity and related diseases》2018,14(2):138-142