DEFECT STUDY
PROJECT LEAD: Patrice Eastwood
Consultant Mentor: Tim Bradnock (Glasgow)
Contact Details: thedefectstudy@gmail.com
Congenital Diaphragmatic Hernia Study
Congenital diaphragmatic hernia occurs in 2.3/10 000 live births in Europe. Currently neonatal survival is around 65% in expert centres, the majority succumbing to pulmonary hypertension and respiratory insufficiency. In-utero treatment, namely FETO, seems to improve survival however the majority (75%) of these patients require a patch postnatally to close the defect. Re-herniation occurs with both primary closure (4%) and patch closure (27%). Intra-operative reporting (CDH study group A-D) and diaphragmatic repair are not universally standardized. Primary repair has been traditionally preferred but there is suggestion that tension free repair may reduce complications namely recurrence. Patch rate varies greatly between centres and some advocate liberal patch use (54%) contributing to a low re-herniation rate (5.4%).
Over a two year period (March 2021- March 2023) with one year follow up in UK, Irish and New Zealand paediatric surgical centres we have the following aims:
Primary aims
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To objectively describe diaphragmatic defects at the time of neonatal CDH repair in UK, New Zealand and Irish centres over two years
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To describe the diaphragmatic repair methods used for neonatally repaired congenital diaphragmatic hernias
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To describe the observed pre-operative physiological parameters related to timing of surgery and their relationship to intraoperative defect size
Secondary aim
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To report complications requiring operative management at 12 months following repair
After registration as an audit in participating centres, anonymised data will be collected and added to a RedCap database. Single corporate authorship policy or headline authorship will be employed.
UPDATE
- Active study/ patient recruitment has begun March 2021
- This study has been collecting data for over a year! We have reached our
recruitment target and will collect follow-up data up to 1 year (March
2024). Initial results were shared at the BAPS annual congress 2023 as
an oral presentation and we look forward to sharing the results with 1
year follow-up in due course. Thanks to everyone involved for your
ongoing efforts.
- Please can all centres keep adding follow-up data for infants including
in this until 1 year follow-up has been reached.
Current number of patients recruited: 30
