title: Mid- and long-term effects on pulmonary perfusion, anatomy and diaphragmatic motility in survivors of congenital diaphragmatic hernia.
abstract: The aim of the present study was to evaluate the pulmonary sequelae and diaphragmatic motility in infant, adolescent and adult patients (pts) who had undergone the repair of a congenital diaphragmatic hernia. Thirty-one (81.5%) out of 38 survivors after left side CDH repair, without using a patch, were followed-up. They were subdivided in two groups. Group A (mid-term follow-up): 12 pts (39%) (5 males, 7 females) with a mean age of 4.5 years; Group B (long-term follow-up): 19 pts (61%) (9 males, 10 females) with a mean age of 21.0 years. All pts underwent physical examination, chest X-ray, diaphragmatic ultrasonographic (US) examination, pulmonary perfusion scintigraphy. Patients of the group B were also submitted to spirometry. All pts had a normal life-style and no one complained of respiratory symptoms. The chest X-ray revealed pathologic findings in 12 pts (39%). 8 pts (26%) showed chest wall alterations. The profile of the left diaphragmatic dome appeared irregular in 9 pts (29%). In all pts M-mode sonography disclosed a reduced diaphragmatic motility on the treated side. The mean pulmonary perfusion scintigraphy value on the affected side was 39.2+/-0.7%. The spirometric study showed normal values. We noted that the lung perfusion significantly and rapidly improved after CDH repair even the apparently hypoplastic and small lungs, the diaphragm maintained a good contractility during forced respiration.
authors.affiliation: Dipartimento di Scienze Pediatriche Mediche e Chirurgiche U.O.C. di Chirurgia Pediatrica, Università degli Studi di Messina, Viale Gazzi A.O.U. Policlinico, Pad. NI, 98125 Messina, Italy. arenaf@unime.it
authors.forename: Francesco
authors.initials: F
authors.lastname: Arena
authors.forename: Sergio
authors.initials: S
authors.lastname: Baldari
authors.forename: Antonio
authors.initials: A
authors.lastname: Centorrino
authors.forename: Maria Pia
authors.initials: MP
authors.lastname: Calabrò
authors.forename: Giovanni
authors.initials: G
authors.lastname: Pajno
authors.forename: Giovanni
authors.initials: G
authors.lastname: Pajino
authors.forename: Salvatore
authors.initials: S
authors.lastname: Arena
authors.forename: Filippo
authors.initials: F
authors.lastname: Andò
authors.forename: Biagio
authors.initials: B
authors.lastname: Zuccarello
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Romeo
mesh_terms: D000293:Adolescent; D000328:Adult; D003952:Diagnostic Imaging; D003964:Diaphragm / Q000473:pathology / Q000503:physiopathology*; D006548:Hernia, Diaphragmatic / Q000473:pathology / Q000503:physiopathology* / Q000601:surgery*; D006801:Humans; D007223:Infant; D008168:Lung / Q000473:pathology / Q000503:physiopathology*; D008297:Male; D010477:Perfusion; D013147:Spirometry; D017741:Survivors