Konjenital Diyafragma Hernisi Tanılı Hastalar; 10 Yıllık Tek Merkez Deneyimi

Year 2023, Volume: 18 Issue: 2, 35 - 38, 12.07.2023

Mehmet Fatih Deveci , Meral Alagöz , İsmail Kürşad Gökce , Ramazan Özdemir

https://doi.org/10.17517/ksutfd.1113448

Abstract

Amaç: Konjenital diyafragma hernisi (KDH), diyafragmanın gelişimsel kusuru olup nadir görülmektedir. Batın içi organların göğüs boşluğuna fıtıklaşması
sonucu gelişen akciğer hipoplazisinin şiddeti, hastaların prognozunda temel etkendir. Biz bu çalışmamızda, son 10 yıllık süreçte KDH vakalarımızla ilgili
deneyimimizi ve mortalite ile ilgili faktörleri değerlendirmeyi amaçladık.
Gereç ve Yöntemler: Ocak 2012-Aralık 2021 tarihleri arasında KDH tanısı ile yatırılan hastaları retrospektif olarak inceledik. Hastaların demografik özellikleri
ile klinik izlem bilgilerini değerlendirip, mortalite üzerinde etkili olan faktörleri inceledik.
Bulgular: Toplam 37 KDH’li hastamızdan, 22’sinin exitus olduğunu tespit ettik. 19 hastamız başka merkezlerde doğup, tarafımıza sevk edilmişti. Ayrıca
19 hastamızın prenatal tanısı yoktu. Hastalardan 12’si opere edilmeden ilk saatlerde exitus oldu. Exitus olan grupta ek anomali oranı [n=13 (%59.1), n=1
(%6.7) sırasıyla (p=0.002)] istatiksel olarak daha fazlaydı. Opere edilen 25 hastamızdan 15’i taburcu edildi. Opere edilenlerden exitus olan grupta, pulmoner
hipertansiyon gelişen hasta sayısı [n=9 (%90), n=4 (%26.7) sırasıyla (p=0.005)] istatiksel olarak daha fazlaydı.
Sonuçlar: Pulmoner hipertansiyon ve ek anomali KDH hastalarında mortalite ile ilişkilidir. Bu hastaların doğumlarının uygun merkezde olması ve deneyimli
ekiplerce takip ve tedavilerinin yapılması da önemlidir.

Keywords

Konjenital diyafragma hernisi, pulmoner hipertansiyon, yenidoğan

Patients with Congenital Diaphragmatic Hernia: 10-Year Single Center Experience

Abstract

Objective: Congenital diaphragmatic hernia (CDH) is a developmental defect of the diaphragm and is rarely seen. The severity of lung hypoplasia, which
develops as a result of herniation of abdominal organs into the chest cavity, is the main factor in the prognosis of patients. In this study, we aimed to evaluate
our last10-year experience of CDH cases and mortality-related factors.
Materials and Methods: We retrospectively analyzed the patients hospitalized with the diagnosis of CDH between January 2012 and December 2021. We
evaluated the demographic characteristics and clinical follow-up information of the patients and examined the factors affecting mortality.
Results: We found that out of 37 patients with CDH, 22 of them were died. 19 of our patients were born in other centers and referred to our center. In addition,
19 of our patients did not have a prenatal diagnosis. The rate of additional anomaly in the exitus group was statistically higher [n=13 (59.1%), n=1
(6.7%) respectively (p=0.002)]. 12 of the patients died in the first hours without surgery. 15 of our operated 25 patients were discharged. The number of
patients who developed pulmonary hypertension in the exitus group was statistically higher [n=9 (90%), n=4 (26.7%), respectively (p=0.005)].
Conclusion: Pulmonary hypertension and additional anomaly are associated with mortality in patients with CDH. It is also important that these patients are
delivered at the appropriate center and followed up and treated by experienced teams.

Keywords

Congenital diaphragmatic hernia, pulmonary hypertension, newborn

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