Skip to main content
PMC home page
Archives of Disease in Childhood logoLink to Archives of Disease in Childhood
. 1992 Nov;67(11):1353–1356. doi: 10.1136/adc.67.11.1353

Delayed surgery for congenital diaphragmatic hernia: neurodevelopmental outcome in later childhood.

M Davenport 1, E Rivlin 1, S W D'Souza 1, A Bianchi 1
PMCID: PMC1793771  PMID: 1281972

Abstract

The long term neurodevelopmental outcome was assessed in 23 survivors born with congenital diaphragmatic hernia who had been managed by an elective delay in surgical repair after a period of stabilisation. This cohort was treated in one neonatal surgical unit between 1983 and 1989 by a single team of surgeons and anaesthetists. All children underwent comprehensive neurological, developmental, and anthropometric assessment at a mean age of 56 (range 18-94) months. Two children (9%) had major disability (one with hemiplegia and one with a lower limb monoplegia) and two further children had minor disabilities (one had partial sightedness and squint, the other squint only). The mean developmental quotient (DQ) for the group was 108 (SD 10.8) and none had developmental delay (defined as DQ < 70). Infants who had spent more time in hospital, or had had a longer duration of ventilation, tended to have lower weights and lower occipitofrontal circumference centiles in later childhood. Preoperative stabilisation and delayed surgery for congenital diaphragmatic hernia is not associated with an impaired neurodevelopmental outcome.

Full text

PDF
1353

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Adolph V., Ekelund C., Smith C., Starrett A., Falterman K., Arensman R. Developmental outcome of neonates treated with extracorporeal membrane oxygenation. J Pediatr Surg. 1990 Jan;25(1):43–46. doi: 10.1016/s0022-3468(05)80162-9. [DOI] [PubMed] [Google Scholar]
  2. Adzick N. S., Harrison M. R., Glick P. L., Nakayama D. K., Manning F. A., deLorimier A. A. Diaphragmatic hernia in the fetus: prenatal diagnosis and outcome in 94 cases. J Pediatr Surg. 1985 Aug;20(4):357–361. doi: 10.1016/s0022-3468(85)80219-0. [DOI] [PubMed] [Google Scholar]
  3. Calvert S. A., Hoskins E. M., Fong K. W., Forsyth S. C. Etiological factors associated with the development of periventricular leukomalacia. Acta Paediatr Scand. 1987 Mar;76(2):254–259. doi: 10.1111/j.1651-2227.1987.tb10456.x. [DOI] [PubMed] [Google Scholar]
  4. Cartlidge P. H., Mann N. P., Kapila L. Preoperative stabilisation in congenital diaphragmatic hernia. Arch Dis Child. 1986 Dec;61(12):1226–1228. doi: 10.1136/adc.61.12.1226. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Charlton A. J., Bruce J., Davenport M. Timing of surgery in congenital diaphragmatic hernia. Low mortality after pre-operative stabilisation. Anaesthesia. 1991 Oct;46(10):820–823. doi: 10.1111/j.1365-2044.1991.tb09592.x. [DOI] [PubMed] [Google Scholar]
  6. Cullen M. L., Klein M. D., Philippart A. I. Congenital diaphragmatic hernia. Surg Clin North Am. 1985 Oct;65(5):1115–1138. doi: 10.1016/s0039-6109(16)43732-1. [DOI] [PubMed] [Google Scholar]
  7. Ginn-Pease M. E., King D. R., Tarnowski K. J., Green L., Young G., Linscheid T. R. Psychosocial adjustment and physical growth in children with imperforate anus or abdominal wall defects. J Pediatr Surg. 1991 Sep;26(9):1129–1135. doi: 10.1016/0022-3468(91)90688-p. [DOI] [PubMed] [Google Scholar]
  8. Hofkosh D., Thompson A. E., Nozza R. J., Kemp S. S., Bowen A., Feldman H. M. Ten years of extracorporeal membrane oxygenation: neurodevelopmental outcome. Pediatrics. 1991 Apr;87(4):549–555. [PubMed] [Google Scholar]
  9. Langer J. C., Filler R. M., Bohn D. J., Shandling B., Ein S. H., Wesson D. E., Superina R. A. Timing of surgery for congenital diaphragmatic hernia: is emergency operation necessary? J Pediatr Surg. 1988 Aug;23(8):731–734. doi: 10.1016/s0022-3468(88)80413-5. [DOI] [PubMed] [Google Scholar]
  10. Lucas A., Gore S. M., Cole T. J., Bamford M. F., Dossetor J. F., Barr I., Dicarlo L., Cork S., Lucas P. J. Multicentre trial on feeding low birthweight infants: effects of diet on early growth. Arch Dis Child. 1984 Aug;59(8):722–730. doi: 10.1136/adc.59.8.722. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Ludman L., Spitz L., Lansdown R. Developmental progress of newborns undergoing neonatal surgery. J Pediatr Surg. 1990 May;25(5):469–471. doi: 10.1016/0022-3468(90)90552-k. [DOI] [PubMed] [Google Scholar]
  12. Reynolds M., Luck S. R., Lappen R. The "critical" neonate with diaphragmatic hernia: a 21-year perspective. J Pediatr Surg. 1984 Aug;19(4):364–369. doi: 10.1016/s0022-3468(84)80254-7. [DOI] [PubMed] [Google Scholar]
  13. Schumacher R. E., Palmer T. W., Roloff D. W., LaClaire P. A., Bartlett R. H. Follow-up of infants treated with extracorporeal membrane oxygenation for newborn respiratory failure. Pediatrics. 1991 Apr;87(4):451–457. [PubMed] [Google Scholar]
  14. Shanbhogue L. K., Tam P. K., Ninan G., Lloyd D. A. Preoperative stabilisation in congenital diaphragmatic hernia. Arch Dis Child. 1990 Oct;65(10 Spec No):1043–1044. doi: 10.1136/adc.65.10_spec_no.1043. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Sinha S. K., D'Souza S. W., Rivlin E., Chiswick M. L. Ischaemic brain lesions diagnosed at birth in preterm infants: clinical events and developmental outcome. Arch Dis Child. 1990 Oct;65(10 Spec No):1017–1020. doi: 10.1136/adc.65.10_spec_no.1017. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Weindling A. M., Wilkinson A. R., Cook J., Calvert S. A., Fok T. F., Rochefort M. J. Perinatal events which precede periventricular haemorrhage and leukomalacia in the newborn. Br J Obstet Gynaecol. 1985 Dec;92(12):1218–1223. doi: 10.1111/j.1471-0528.1985.tb04865.x. [DOI] [PubMed] [Google Scholar]
  17. Wiklund L. M., Uvebrant P. Hemiplegic cerebral palsy: correlation between CT morphology and clinical findings. Dev Med Child Neurol. 1991 Jun;33(6):512–523. doi: 10.1111/j.1469-8749.1991.tb14916.x. [DOI] [PubMed] [Google Scholar]

Articles from Archives of Disease in Childhood are provided here courtesy of BMJ Publishing Group

RESOURCES