Large diaphragmatic defect: are skeletal deformities preventable?

. 2011 Dec ; 27 (12) : 1343-9. [epub] 20110920

Jazyk angličtina Země Německo Médium print-electronic

Typ dokumentu srovnávací studie, časopisecké články, práce podpořená grantem

Perzistentní odkaz   https://www.medvik.cz/link/pmid21932166

PURPOSE: The aim of study was to compare growth, nutritional status and incidence of chest wall deformities and scoliosis in survivors of large congenital diaphragmatic hernia (CDH) defect (Gore-Tex patch reconstruction) with survivors with smaller defects and primary reconstruction. MATERIALS AND METHODS: An anthropometric study of 53 children who underwent CDH repair in neonatal period was carried out. Weight, height, and skin-fold thickness were measured, scoliosis and chest wall deformity were evaluated. Body mass index (BMI) and thoracic index (TI) were calculated using standard rules. The measured data were compared with national population standard with the use of standard deviation score (SDS). According to the type of diaphragmatic reconstruction, the patients were divided into two groups [Gore-Tex patch (10) versus primary repair (43)]. Student t test and Fisher exact tests were used for statistical analysis. RESULTS: Pectus excavatum was found in 25 (47%) patients, poor posture in 33% and significant scoliosis in 5%. Compared with the population norm, CDH children had a significantly lower body height SDS (mean -0.39, p < 0.05), weight SDS (mean -0.75, p < 0.001), BMI (mean SDS -0.68, p < 0.001) and lower TI (mean SDS -0.62, p < 0.01). Gore-Tex versus primary repair group significantly differed in incidence of pectus excavatum and BMI (PE: p = 0.027, BMI SDS: p = 0.016). A majority of anthropometric parameters (weight, height, thoracic index, and thorax circumference) and incidence of scoliosis and poor posture in children after Gore-Tex patch reconstruction did not significantly differ from children after primary repair. CONCLUSION: The differences in some anthropometric parameters (weight, BMI, and TI) and in the skeletal deformity suggest that the CDH not only disturbs normal lung growth, but also seems to have implications on some other aspects of somatic development. Whether these changes could be related to the type of diaphragmatic reconstruction or rather to the size of the defect remains uncertain.

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J Pediatr Surg. 2001 Jan;36(1):152-4 PubMed

Semin Pediatr Surg. 2007 May;16(2):134-44 PubMed

Pediatr Surg Int. 2006 Apr;22(4):335-40 PubMed

J Pediatr Gastroenterol Nutr. 2010 Oct;51(4):448-53 PubMed

J Pediatr Surg. 2004 Apr;39(4):526-31 PubMed

Eur J Pediatr Surg. 2005 Dec;15(6):399-403 PubMed

J Laparoendosc Adv Surg Tech A. 2011 Apr;21(3):267-70 PubMed

J Pediatr Surg. 2006 May;41(5):888-92 PubMed

Pediatr Surg Int. 2009 Jan;25(1):1-17 PubMed

Ann Thorac Surg. 2003 Jan;75(1):250-6 PubMed

J Pediatr Surg. 2007 Apr;42(4):657-65 PubMed

J Pediatr Surg. 2003 Mar;38(3):296-300; discussion 296-300 PubMed

J Pediatr Surg. 2010 May;45(5):953-7 PubMed

J Pediatr Surg. 2010 Jan;45(1):155-60; discussion 160 PubMed

Pediatr Surg Int. 2009 Sep;25(9):733-43 PubMed

Pediatr Surg Int. 1997 Mar 21;12(2/3):95-100 PubMed

Pediatr Surg Int. 2007 Jan;23(1):27-31 PubMed

Pediatrics. 2007 Sep;120(3):e651-7 PubMed

J Pediatr Surg. 2001 Aug;36(8):1171-6 PubMed

J Pediatr Surg. 2006 Jan;41(1):29-33; discussion 29-33 PubMed

J Pediatr Surg. 1998 Jul;33(7):1004-9 PubMed

Semin Perinatol. 2004 Jun;28(3):174-84 PubMed

J Pediatr Surg. 2011 Jan;46(1):52-6 PubMed

Pediatr Surg Int. 2011 Sep;27(9):969-74 PubMed

Pediatr Surg Int. 2009 Dec;25(12):1059-64 PubMed

J Pediatr Surg. 2010 Jan;45(1):151-4 PubMed

Pediatr Pulmonol. 2005 May;39(5):433-9 PubMed

J Pediatr Surg. 1996 Jun;31(6):851-4 PubMed

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