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

  1. To objectively describe diaphragmatic defects at the time of neonatal CDH repair in UK, New Zealand and Irish centres over two years

  2. To describe the diaphragmatic repair methods used for neonatally repaired congenital diaphragmatic hernias

  3. To describe the observed pre-operative physiological parameters related to timing of surgery and their relationship to intraoperative defect size

Secondary aim

  • 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

Trial data collection completed, with active study to begin March 2021
 

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