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23.09.2022 | Original Article

The efficacy of the postnatal nasogastric tube position as a prognostic marker of left-sided isolated congenital diaphragmatic hernia

verfasst von: Jun Kono, Kouji Nagata, Keita Terui, Shoichiro Amari, Katsuaki Toyoshima, Noboru Inamura, Yuhki Koike, Masaya Yamoto, Tadaharu Okazaki, Yuta Yazaki, Hiroomi Okuyama, Masahiro Hayakawa, Taizo Furukawa, Kouji Masumoto, Akiko Yokoi, Noriaki Usui, Tatsuro Tajiri

Erschienen in: Pediatric Surgery International | Ausgabe 12/2022

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Abstract

Purpose

The prenatal diagnosis of the stomach position in congenital diaphragmatic hernia (CDH) has been a reliable prognostic factor, but few studies have focused on the postnatal position. We therefore evaluated the significance of the nasogastric (NG) tube position just after birth.

Methods

The Japanese CDH Study Group database enrolled 1037 CDH neonates over 15 years. In our multicenter retrospective study, 464 cases of left-sided isolated CDH with prenatal diagnoses were divided into two groups: NG tube below the diaphragm (BD; n = 190) or above the diaphragm (AD; n = 274). The primary outcome was the 90-day survival rate, and the secondary outcomes were mechanical ventilation duration, hospitalization duration, and recurrence rate.

Results

The BD group had a significantly higher 90-day survival rate (98.4 vs. 89.4%, p < 0.001), shorter mechanical ventilation (11 vs. 19 days, p < 0.001), shorter hospitalization (38 vs. 59 days, p < 0.001), and lower recurrence rate (p = 0.002) than the AD group. A multivariate analysis showed that BD (adjusted odds ratio, 3.68; 95% confidence interval 1.02–13.30) was a favorable prognostic factor for the 90-day survival.

Conclusion

The assessment of the NG tube position revealed it to be a reliable prognostic factor of left-sided isolated CDH. Therefore, it should be included as a routine assessment.

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Titel: The efficacy of the postnatal nasogastric tube position as a prognostic marker of left-sided isolated congenital diaphragmatic hernia
verfasst von: Jun Kono
Kouji Nagata
Keita Terui
Shoichiro Amari
Katsuaki Toyoshima
Noboru Inamura
Yuhki Koike
Masaya Yamoto
Tadaharu Okazaki
Yuta Yazaki
Hiroomi Okuyama
Masahiro Hayakawa
Taizo Furukawa
Kouji Masumoto
Akiko Yokoi
Noriaki Usui
Tatsuro Tajiri
Publikationsdatum: 23.09.2022
Verlag: Springer Berlin Heidelberg
Erschienen in: Pediatric Surgery International / Ausgabe 12/2022
Print ISSN: 0179-0358
Elektronische ISSN: 1437-9813
DOI: https://doi.org/10.1007/s00383-022-05226-8

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The efficacy of the postnatal nasogastric tube position as a prognostic marker of left-sided isolated congenital diaphragmatic hernia