Is delayed surgery really better for congenital diaphragmatic hernia?: A prospective randomized clinical trial
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Cited by (58)
Surgical Management of Congenital Diaphragmatic Hernia
2022, Clinics in PerinatologyOperative repair in congenital diaphragmatic hernia: How long do we really need to wait?
2022, Journal of Pediatric SurgeryCitation Excerpt :Early repair was defined as up to 4–6 h age, whereas late repair was greater than 24 or 96 h of life, respectively. Relative to current data from the CDH Registry, ECMO rates in the Nio et al. study were very high in both study arms, 67% (early) and 89% (late), while survival rates were quite low in both groups of the trial by de la Hunt, 46% (early) and 57% (late) [9,10]. Subsequently, recommendations have been made by several study groups to repair the defect when “physiologic stability has been achieved” [12–14].
Impact of Objective Echocardiographic Criteria for Timing of Congenital Diaphragmatic Hernia Repair
2018, Journal of PediatricsManagement of congenital diaphragmatic hernia: A systematic review from the APSA outcomes and evidence based practice committee
2015, Journal of Pediatric SurgeryCitation Excerpt :Based on these results, they concluded that there was no advantage to early or late repair and advocated for individualization of care based on clinical course, with the stable ones repaired early and the others later when stabilized. De la Hunt et al. [86] performed a similar trial in the UK over the same time period. Their goal was to randomize 60 cases over 4 years, but they stopped at 54 patients due to accrual issues.
Controversies in the management of severe congenital diaphragmatic hernia
2014, Seminars in Fetal and Neonatal MedicineCitation Excerpt :Although it seems reasonable to delay surgical intervention to improve the physiologic derangements and to reduce the risks of iatrogenic injuries leading to rapid, potentially irreversible, deterioration of the clinical status, scientific evidence is lacking. There are two prospective randomized clinical trials comparing early versus delayed CDH repair and one systematic Cochrane review that have failed to show a difference in mortality and neonatal morbidity [109–111]. These studies were conducted in the late 1990s.
A risk-stratified analysis of delayed congenital diaphragmatic hernia repair: Does timing of operation matter?
2014, Surgery (United States)Citation Excerpt :However, the exact definition or criteria for timing of operation remains unknown. Although several reports have advocated for a delayed strategy of hemodynamic stability before operative repair, the definition of physiologic stability can be variable.5,17-21 Some centers have defined stability and indications for repair in high-risk patients who require operative repair on ECMO16; however, few data exist outlining timing of repair in lower risk infants with CDH.