Postnatal Ultrasound to Determine the Surgical Strategy for Congenital Diaphragmatic Hernia

Takahiro Hosokawa, Yoshitake Yamada, Hiroaki Takahashi, Yutaka Tanami, Yumiko Sato, Tetsuya Ishimaru, Yujiro Tanaka, Hiroshi Kawashima, Mayumi Hosokawa, Eiji Oguma

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

OBJECTIVES: To compare defect sizes in congenital diaphragmatic hernia (CDH) measured by postnatal ultrasound (US) between neonates who underwent thoracoscopic surgery and neonates who underwent open surgery and between neonates who underwent primary repair and those who underwent patch repair; additionally, to compare the accuracy of US diagnosis with that of surgical diagnosis for the location of the diaphragmatic hernia and the hernial contents. METHODS: We included 8 neonates who underwent preoperative US evaluations of CDH. We compared anterior-to-posterior diaphragm defect sizes between thoracoscopic and open surgery approaches and between primary and patch repair by using the Mann-Whitney U test. The diaphragm was divided into 3 segments: anterior, lateral, and posterior. We evaluated the location of the diaphragmatic hernia and the hernial contents. RESULTS: Four neonates who underwent open surgery had larger diaphragmatic hernias than those who underwent thoracoscopic surgery (mean ± SD, 30.5 ± 5.6 versus 16.3 ± 3.3 mm; P = .030). They were also larger in neonates who underwent patch repair than in those who underwent primary repair (33.0 ± 3.0 versus 17.6 ± 4.2 mm; P = .037). Detection of anterior and lateral diaphragm segments was consistent between US and surgical findings. Three of 4 neonates who underwent open surgery and all 3 neonates who underwent patch repair did not show the lateral segment. The hernial contents were also consistent between US and surgical findings. CONCLUSIONS: Postnatal US examinations of neonates with CDH could provide surgeons with useful information to determine the surgical approach and repair method. However, since our study cohort was small, further studies are needed with a larger number of neonates with CDH.

Original languageEnglish
Pages (from-to)2347-2358
Number of pages12
JournalJournal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine
Volume38
Issue number9
DOIs
Publication statusPublished - 2019 Sep 1

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Newborn Infant
Thoracoscopy
Diaphragmatic Hernia
Diaphragm
Congenital Diaphragmatic Hernias
Nonparametric Statistics
Cohort Studies

Keywords

  • Bochdalek hernia
  • congenital diaphragmatic hernia
  • patch repair
  • thoracoscopic surgery
  • ultrasound

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology
  • Radiology Nuclear Medicine and imaging

Cite this

Postnatal Ultrasound to Determine the Surgical Strategy for Congenital Diaphragmatic Hernia. / Hosokawa, Takahiro; Yamada, Yoshitake; Takahashi, Hiroaki; Tanami, Yutaka; Sato, Yumiko; Ishimaru, Tetsuya; Tanaka, Yujiro; Kawashima, Hiroshi; Hosokawa, Mayumi; Oguma, Eiji.

In: Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine, Vol. 38, No. 9, 01.09.2019, p. 2347-2358.

Research output: Contribution to journalArticle

Hosokawa, Takahiro ; Yamada, Yoshitake ; Takahashi, Hiroaki ; Tanami, Yutaka ; Sato, Yumiko ; Ishimaru, Tetsuya ; Tanaka, Yujiro ; Kawashima, Hiroshi ; Hosokawa, Mayumi ; Oguma, Eiji. / Postnatal Ultrasound to Determine the Surgical Strategy for Congenital Diaphragmatic Hernia. In: Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine. 2019 ; Vol. 38, No. 9. pp. 2347-2358.
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T1 - Postnatal Ultrasound to Determine the Surgical Strategy for Congenital Diaphragmatic Hernia

AU - Hosokawa, Takahiro

AU - Yamada, Yoshitake

AU - Takahashi, Hiroaki

AU - Tanami, Yutaka

AU - Sato, Yumiko

AU - Ishimaru, Tetsuya

AU - Tanaka, Yujiro

AU - Kawashima, Hiroshi

AU - Hosokawa, Mayumi

AU - Oguma, Eiji

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N2 - OBJECTIVES: To compare defect sizes in congenital diaphragmatic hernia (CDH) measured by postnatal ultrasound (US) between neonates who underwent thoracoscopic surgery and neonates who underwent open surgery and between neonates who underwent primary repair and those who underwent patch repair; additionally, to compare the accuracy of US diagnosis with that of surgical diagnosis for the location of the diaphragmatic hernia and the hernial contents. METHODS: We included 8 neonates who underwent preoperative US evaluations of CDH. We compared anterior-to-posterior diaphragm defect sizes between thoracoscopic and open surgery approaches and between primary and patch repair by using the Mann-Whitney U test. The diaphragm was divided into 3 segments: anterior, lateral, and posterior. We evaluated the location of the diaphragmatic hernia and the hernial contents. RESULTS: Four neonates who underwent open surgery had larger diaphragmatic hernias than those who underwent thoracoscopic surgery (mean ± SD, 30.5 ± 5.6 versus 16.3 ± 3.3 mm; P = .030). They were also larger in neonates who underwent patch repair than in those who underwent primary repair (33.0 ± 3.0 versus 17.6 ± 4.2 mm; P = .037). Detection of anterior and lateral diaphragm segments was consistent between US and surgical findings. Three of 4 neonates who underwent open surgery and all 3 neonates who underwent patch repair did not show the lateral segment. The hernial contents were also consistent between US and surgical findings. CONCLUSIONS: Postnatal US examinations of neonates with CDH could provide surgeons with useful information to determine the surgical approach and repair method. However, since our study cohort was small, further studies are needed with a larger number of neonates with CDH.

AB - OBJECTIVES: To compare defect sizes in congenital diaphragmatic hernia (CDH) measured by postnatal ultrasound (US) between neonates who underwent thoracoscopic surgery and neonates who underwent open surgery and between neonates who underwent primary repair and those who underwent patch repair; additionally, to compare the accuracy of US diagnosis with that of surgical diagnosis for the location of the diaphragmatic hernia and the hernial contents. METHODS: We included 8 neonates who underwent preoperative US evaluations of CDH. We compared anterior-to-posterior diaphragm defect sizes between thoracoscopic and open surgery approaches and between primary and patch repair by using the Mann-Whitney U test. The diaphragm was divided into 3 segments: anterior, lateral, and posterior. We evaluated the location of the diaphragmatic hernia and the hernial contents. RESULTS: Four neonates who underwent open surgery had larger diaphragmatic hernias than those who underwent thoracoscopic surgery (mean ± SD, 30.5 ± 5.6 versus 16.3 ± 3.3 mm; P = .030). They were also larger in neonates who underwent patch repair than in those who underwent primary repair (33.0 ± 3.0 versus 17.6 ± 4.2 mm; P = .037). Detection of anterior and lateral diaphragm segments was consistent between US and surgical findings. Three of 4 neonates who underwent open surgery and all 3 neonates who underwent patch repair did not show the lateral segment. The hernial contents were also consistent between US and surgical findings. CONCLUSIONS: Postnatal US examinations of neonates with CDH could provide surgeons with useful information to determine the surgical approach and repair method. However, since our study cohort was small, further studies are needed with a larger number of neonates with CDH.

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KW - thoracoscopic surgery

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