title: Right- versus left-sided congenital diaphragmatic hernia: a comparative outcomes analysis.
abstract: OBJECTIVE
  Right-sided congenital diaphragmatic hernia (R-CDH) occurs in up to 25% of all CDH cases, but has been less widely studied compared to left-sided defects. We sought to compare characteristics and outcomes of left- versus right-sided defects in a large cohort of CDH patients who underwent standardized treatment and follow-up at a single institution.
  
  
  METHODS
  We retrospectively reviewed charts of all CDH patients in our pulmonary hypoplasia program from January 2002 through December 2014. Categorical variables were analyzed by Fisher's exact test and continuous variables by Mann-Whitney t-test (p≤0.05).
  
  
  RESULTS
  A total of 330 CDH patients were treated more than the 12-year study period, with 274 (83%) left-sided and 56 (17%) right-sided cases identified. Specific pulmonary morbidities were associated with R-CDH, with increased duration of nitric oxide therapy, increased requirement for tracheostomy, increased requirement for supplemental oxygen at the time of NICU discharge, and increased chronic pulmonary hypertension with requirement for long-term Sildenafil therapy.
  
  
  CONCLUSIONS
  In this series, R-CDH was not associated with increased mortality, but was associated with increased requirement for pulmonary vasodilatory therapy and requirement for tracheostomy. The high incidence of pulmonary complications indicates increased severity of pulmonary hypoplasia in R-CDH, supporting a role for delivery in tertiary centers with expertise in CDH management.
authors.affiliation: The Center for Fetal Diagnosis and Treatment, Children's Hospital of Philadelphia, Philadelphia, PA.
authors.forename: Emily A
authors.initials: EA
authors.lastname: Partridge
authors.affiliation: The Center for Fetal Diagnosis and Treatment, Children's Hospital of Philadelphia, Philadelphia, PA.
authors.forename: William H
authors.initials: WH
authors.lastname: Peranteau
authors.affiliation: The Center for Fetal Diagnosis and Treatment, Children's Hospital of Philadelphia, Philadelphia, PA.
authors.forename: Lisa
authors.initials: L
authors.lastname: Herkert
authors.affiliation: The Center for Fetal Diagnosis and Treatment, Children's Hospital of Philadelphia, Philadelphia, PA.
authors.forename: Norma
authors.initials: N
authors.lastname: Rendon
authors.affiliation: The Center for Fetal Diagnosis and Treatment, Children's Hospital of Philadelphia, Philadelphia, PA.
authors.forename: Haylee
authors.initials: H
authors.lastname: Smith
authors.affiliation: The Center for Fetal Diagnosis and Treatment, Children's Hospital of Philadelphia, Philadelphia, PA.
authors.forename: Natalie E
authors.initials: NE
authors.lastname: Rintoul
authors.affiliation: The Center for Fetal Diagnosis and Treatment, Children's Hospital of Philadelphia, Philadelphia, PA.
authors.forename: Alan W
authors.initials: AW
authors.lastname: Flake
authors.affiliation: The Center for Fetal Diagnosis and Treatment, Children's Hospital of Philadelphia, Philadelphia, PA.
authors.forename: N Scott
authors.initials: NS
authors.lastname: Adzick
authors.affiliation: The Center for Fetal Diagnosis and Treatment, Children's Hospital of Philadelphia, Philadelphia, PA. Electronic address: Hedrick@email.chop.edu.
authors.forename: Holly L
authors.initials: HL
authors.lastname: Hedrick
mesh_terms: D005260:Female; D005544:Forecasting; D065630:Hernias, Diaphragmatic, Congenital / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D059685:Herniorrhaphy / Q000379:methods*; D006801:Humans; D006976:Hypertension, Pulmonary / Q000150:complications* / Q000453:epidemiology; D015994:Incidence; D007231:Infant, Newborn; D008297:Male; D012189:Retrospective Studies; D014481:United States / Q000453:epidemiology
keywords: Congenital diaphragmatic hernia; Pulmonary hypertension; Survival