Yamoto Masaya, Nagata Kouji, Terui Keita, Hayakawa Masahiro, Okuyama Hiroomi, Amari Shoichiro, Yokoi Akiko, Masumoto Kouji, Okazaki Tadaharu, Inamura Noboru, Toyoshima Katsuaki, Koike Yuhki, Yazaki Yuta, Furukawa Taizo, Usui Noriaki
Department of Pediatric Surgery, Shizuoka Children's Hospital, Shizuoka 420-8660, Japan.
Department of Pediatric Surgery, Reproductive and Developmental Medicine, Faculty of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-Ku, Fukuoka 812-8582, Japan.
Children (Basel). 2022 Jun 8;9(6):856. doi: 10.3390/children9060856.
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).
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.
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.
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.
近年来，先天性膈疝（CDH）新生儿的治疗方式有了很大改进，存活率也随之提高。然而，长期预后限制了为青春期和成年期的CDH幸存者确定最佳护理途径。因此，我们在日本CDH研究组（JCDHSG）内评估了长期预后。
根据JCDHSG，参与者于2006年至2018年期间出生时患有CDH。参与者在1.5岁、3岁、6岁和12岁时被纳入数据库。随访项目包括长期并发症、针对长期并发症的手术以及家庭医疗护理。
本研究共纳入747例患者，其中626例存活（83.8%），121例未存活（16.2%）。在1.5岁、3岁、6岁和12岁时，分别有45.4%、36.5%、34.8%和43.6%的患者出现并发症，分别有20.1%、14.7%、11.5%和5.1%的参与者需要家庭护理。复发、肺炎、气胸、胃食管反流病和肠梗阻随年龄增长而减少，胸廓畸形随年龄增长而增加。
随着CDH存活率的提高，需要持续开展研究并对长期护理进行微调，以优化适当的监测和长期随访。
