Pediatric Surgery International

, Volume 35, Issue 3, pp 303–313 | Cite as

Congenital diaphragmatic hernia: the good, the bad, and the tough

  • Emrah AydinEmail author
  • Foong-Yen Lim
  • Paul Kingma
  • Beth Haberman
  • Beth Rymeski
  • Patricia Burns
  • Jose L. Peiro
Original Article



We aim to determine factors that are associated with better outcomes of CDH patients.


A retrospective review was performed on all CDH patients admitted to our institution between 2003 and 2016. This study was performed at a single institution which has a fetal care center. Patients admitted with CDH with at least 1-year follow-up during the analysis were included in the study.


Twenty-six (13.8%) patients had a hernia sac, 124 (59%) patients had liver herniation, and 56 (25.1%) patients had an accompanying syndrome. Overall survival to discharge was 73.1% while overall survival to date was 69.5%. The presence of a hernia sac, liver herniation, and accompanying syndromes showed as independent predictors influencing the survival, B 1.968, p = 0.04, OR 7.158, 95% CI 0.907–56.485, B − 1.178, p = 0.01, OR 3.932, 95% CI 1.798–8.602 and B − 1.032, p = 0.05, OR 2.795, 95% CI 0.976–7.764, respectively.


In our CDH cohort, the presence of a hernia sac was proven to be associated with better outcomes, while thoracic herniation of the liver was associated with worse outcomes. The accompanying syndromes although being more difficult to manage had a little effect on the outcome of the disease itself.


Congenital diaphragmatic hernia Hernia sac Liver herniation Syndrome Prognostic factors Cardiac anomalies 


Author contributions

All authors have made substantial contributions to the conception and design of the study, acquisition, analysis, and interpretation of data, drafting the article and revising it for important intellectual content and final approval of the version to be submitted.


This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Compliance with ethical standards

Conflict of interest

The authors report no proprietary or commercial interest in any product mentioned or concept discussed in this article.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee (IRB #2017-6361) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Division of Pediatric General and Thoracic Surgery, The Center for Fetal Cellular and Molecular TherapyCincinnati Fetal CenterCincinnatiUSA
  2. 2.Division of Neonatology and Pulmonary BiologyCincinnati Children’s Hospital Medical CenterCincinnatiUSA

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