[Risk factors for the development of severe gastroesophageal reflux in neonates with congenital diaphragmatic hernia surgery].

BACKGROUND

Gastroesophageal reflux after congenital diaphramatic hernia surgical correction occurs in up to 89 % of patients, out of which 20 to 30 % will require surgical management. Identification of risk factors for the development of this complication might allow for a Nissen fundoplication to be performed at the sime surgical time in those requiring it. The purpose of this research was to identify those factors in children with diaphragmatic hernia surgery.

METHODS

A case-control study was conducted, where patients with diaphragmatic hernia surgery treated between 2006 and 2011 were included. Patients with severe gastroesophageal reflux were regarded as the cases, whereas those who did not develop it over the 1-year follow up were the controls.

RESULTS

Nine patients developed severe gastroesophageal reflux after the diaphragmatic hernia surgery. A large size of the hernia, it containing 4 or more organs, 10 days or more of ventilatory support requirement after the surgery or high mechanical ventilation variables significantly increased the risk for the development of severe gastroesophageal reflux.

CONCLUSIONS

Presurgical risk factors such as large hernias or hernias containing more than 4 organs might suggest the convenience of conducting a fundoplication at the same time of the diaphramatic hernia surgical correction.