Congenital diaphragmatic hernia: Prognostic value of hernia sac and size of defect: An original article

The aim of this study was to evaluate the effect of the presence of hernia sac and defect size on the prognosis of CDH in our pediatric hospital.

In this prospective study all the infants with the diagnosis of CDH that were admitted in the Tabriz Pediatric Hospital since 2016- 2019 were enrolled. Laparatomy was performed when the patients were stabilized. Presence or absence of hernia sac was evaluated and the largest diameter on diaphragmatic defect was measured before the repair. Postoperative outcome including instability, duration of mechanical ventilation, mortality rate or hospital discharge were obtained and analyzed.

Fifteen cases were diagnosed during the first 24 hours of life and Sixteen cases experienced hypoxia in the first hour after birth. Left sided CDH was detected in 26 patients (86.66%), 3 patients (10%) had right sided defect and in one case diaphragmatic defect was bilateral. Hernia sac was present in the 8 cases. Mortality rate was 30% (9 cases) in postoperative period. Mean diameter of defect size in survived group was lower than nonsurvived group (4.12±0.61cm vs. 4.61±0.48; P=0.09). Postoperative death, occurred in 9 of patients without hernia sac but none of cases with hernia sac expired (P= 0.035).

In our study the presence of hernia sac was related to lower postoperative mortality rate. Defect size in survived group was also lower. We suggested presence of hernia sac and lower diameter of defect size acting as good prognostic factors in outcome of patients with CDH.