Study on Factors Associated With Development of Pectus Excavatum in Patients With Congenital Diaphragmatic Hernia

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  • Takayama Keita
    Department of Pediatric Surgery, Osaka Women’s and Children’s Hospital
  • Umeda Satoshi
    Department of Pediatric Surgery, Osaka Women’s and Children’s Hospital
  • Yoshida Mina
    Department of Pediatric Surgery, Osaka Women’s and Children’s Hospital
  • Sakai Takaaki
    Department of Pediatric Surgery, Osaka Women’s and Children’s Hospital
  • Uga Naoko
    Department of Pediatric Surgery, Osaka Women’s and Children’s Hospital
  • Maekawa Shohei
    Department of Pediatric Surgery, Osaka Women’s and Children’s Hospital
  • Yamamichi Taku
    Department of Pediatric Surgery, Osaka Women’s and Children’s Hospital
  • Usui Noriaki
    Department of Pediatric Surgery, Osaka Women’s and Children’s Hospital

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Other Title
  • 先天性横隔膜ヘルニア術後における漏斗胸発生因子の検討
  • センテンセイ オウカクマク ヘルニア ジュツゴ ニ オケル ジョウゴ キョウ ハッセイ インシ ノ ケントウ

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Abstract

<p>Purpose: To determine the clinical factors associated with the development of pectus excavatum (PE) following the repair of a congenital diaphragmatic hernia (CDH).</p><p>Methods: We retrospectively analyzed the medical records of patients with CDH who underwent surgical intervention during the neonatal period at our institution from January 2001 to December 2018 and were followed-up for at least three years postoperatively. We examined the clinical backgrounds of the patients and the CDH severity index to analyze the occurrence of PE.</p><p>Results: Among the 89 patients with CDH who underwent surgery, 23 (25.8%) developed PE. The percentage of patients who underwent nitric oxide (NO) inhalation was significantly higher in patients with PE (100%) than in those without PE (80%). The duration of mechanical ventilation was significantly longer in patients with PE (16 days; 5–44 days) than in those without PE (10 days; 1–1,824 days). Additionally, the duration of oxygen administration was significantly longer in patients with PE (37 days; 6–817 days) than in those without PE (20 days; 4–1,824 days). The percentage of patients who underwent surgery with patch closure was higher in those with PE (16 patients; 70%) than in those without PE (30 patients; 45%). However, the difference was not statistically significant.</p><p>Conclusions: The development of PE following CDH repair was closely related to the type of respiratory management, such as the use of NO, mechanical ventilation, and oxygen therapy.</p>

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