{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T12:25:02Z","timestamp":1772108702812,"version":"3.50.1"},"reference-count":21,"publisher":"Georg Thieme Verlag KG","issue":"03","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Eur J Pediatr Surg"],"published-print":{"date-parts":[[2021,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Introduction\u2003A developing body of literature suggests that the presence of a hernia sac in fetuses with congenital diaphragmatic hernia (CDH) may indicate improved prognosis. By examining a large cohort of CDH newborns admitted to a single United Kingdom specialist center, we aimed to establish if presence of hernia sac is a robust predictor of improved survival.<\/jats:p><jats:p>\n          Materials and Methods\u2003All CDH patients admitted to a single center were recruited. Postneonatal presentations and Morgagni hernias were excluded. Demographics, defect type, laterality, survival, and hernia recurrence were recorded.<\/jats:p><jats:p>\n          Results\u2003In this study, 192 CDH newborns were managed from 1997 to 2017; 39 were excluded (10 Morgagni and 29 postneonatal); 22 (14%) neonates had a hernia sac. Survival in patients with a hernia sac was 21\/22 (95%) versus 107\/124 (86%) in cases without hernia sac (p\u2009=\u20090.2). There was no difference in hernia sac proportion by gender (male:female 15 vs. 13.2%, p\u2009=\u20090.8).<\/jats:p><jats:p>\n          Conclusion\u2003In contrast to studies showing a survival advantage, albeit with smaller patient numbers, we report a statistical nonsignificant benefit of hernia sac. Better survival outcomes at this specialist center with CDH patients without a hernia sac than reported in other published studies are likely responsible for the lack of statistical significance observed, despite a larger cohort. National and international CDH registries yielding \u201cbig data\u201d may provide further answers on the utility of a CDH hernia sac as a new prognostic scoring tool.<\/jats:p>","DOI":"10.1055\/s-0040-1713131","type":"journal-article","created":{"date-parts":[[2020,6,11]],"date-time":"2020-06-11T22:40:36Z","timestamp":1591915236000},"page":"276-281","source":"Crossref","is-referenced-by-count":2,"title":["Does the Presence of a Hernia Sac Improve Survival in Newborns with Congenital Diaphragmatic Hernia? A United Kingdom Single-Center Experience"],"prefix":"10.1055","volume":"31","author":[{"given":"Wajid","family":"Jawaid","sequence":"additional","affiliation":[{"name":"Department of Paediatric Surgery, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kit","family":"Sampat","sequence":"additional","affiliation":[{"name":"Division of Child Health, Institute of Child Health, Alder Hey Children' Hospital, University of Liverpool, Liverpool, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul D.","family":"Losty","sequence":"additional","affiliation":[{"name":"Division of Child Health, Institute of Child Health, Alder Hey Children' Hospital, University of Liverpool, Liverpool, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2020,6,11]]},"reference":[{"issue":"14","key":"ref1","doi-asserted-by":"crossref","first-page":"1107","DOI":"10.1002\/bdr2.1357","article-title":"Trends, correlates, and survival of infants with congenital diaphragmatic hernia and its subtypes","volume":"110","author":"R Ramakrishnan","year":"2018","journal-title":"Birth Defects Res"},{"issue":"01","key":"ref2","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1055\/s-0038-1668563","article-title":"First population-based report of infants with congenital diaphragmatic hernia: 30-Day outcomes from the American College of Surgeons National Quality Improvement Program","volume":"29","author":"E Zani-Ruttenstock","year":"2019","journal-title":"Eur J Pediatr Surg"},{"issue":"02","key":"ref3","doi-asserted-by":"crossref","first-page":"144","DOI":"10.1111\/j.1365-3016.2010.01172.x","article-title":"Epidemiology and outcome of congenital diaphragmatic hernia: a 9-year experience","volume":"25","author":"J C Wright","year":"2011","journal-title":"Paediatr Perinat Epidemiol"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"532","DOI":"10.1542\/peds.112.3.532","article-title":"Nihilism in the 1990s: the true mortality of congenital diaphragmatic hernia","volume":"112","author":"G Stege","year":"2003","journal-title":"Pediatrics"},{"issue":"04","key":"ref5","doi-asserted-by":"crossref","first-page":"651","DOI":"10.1016\/j.jpedsurg.2018.04.008","article-title":"Prenatally versus postnatally diagnosed congenital diaphragmatic hernia - side, stage, and outcome","volume":"54","author":"C M Burgos","year":"2019","journal-title":"J Pediatr Surg"},{"issue":"06","key":"ref6","doi-asserted-by":"crossref","first-page":"F517","DOI":"10.1136\/archdischild-2017-313933","article-title":"Early population-based outcomes of infants born with congenital diaphragmatic hernia","volume":"103","author":"A-M Long","year":"2018","journal-title":"Arch Dis Child Fetal Neonatal Ed"},{"issue":"02","key":"ref7","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1002\/uog.1711","article-title":"Fetoscopic tracheal occlusion (FETO) for severe congenital diaphragmatic hernia: evolution of a technique and preliminary results","volume":"24","author":"J Deprest","year":"2004","journal-title":"Ultrasound Obstet Gynecol"},{"issue":"20","key":"ref8","doi-asserted-by":"crossref","first-page":"1916","DOI":"10.1056\/NEJMoa035005","article-title":"A randomized trial of fetal endoscopic tracheal occlusion for severe fetal congenital diaphragmatic hernia","volume":"349","author":"M R Harrison","year":"2003","journal-title":"N Engl J Med"},{"issue":"06","key":"ref9","doi-asserted-by":"crossref","first-page":"897","DOI":"10.1002\/uog.5164","article-title":"How useful is the lung-to-head ratio in predicting outcome in the fetus with congenital diaphragmatic hernia? A systematic review and meta-analysis","volume":"30","author":"M E Ba'ath","year":"2007","journal-title":"Ultrasound Obstet Gynecol"},{"issue":"05","key":"ref10","doi-asserted-by":"crossref","first-page":"609","DOI":"10.1002\/uog.7586","article-title":"Value of liver herniation in prediction of outcome in fetal congenital diaphragmatic hernia: a systematic review and meta-analysis","volume":"35","author":"D Mullassery","year":"2010","journal-title":"Ultrasound Obstet Gynecol"},{"issue":"01","key":"ref11","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1067\/mpd.2002.125004","article-title":"Influence of congenital heart disease on survival in children with congenital diaphragmatic hernia","volume":"141","author":"M S Cohen","year":"2002","journal-title":"J Pediatr"},{"issue":"03","key":"ref12","doi-asserted-by":"crossref","first-page":"286","DOI":"10.1002\/uog.11189","article-title":"Prognostic value of a hernia sac in congenital diaphragmatic hernia","volume":"41","author":"E Spaggiari","year":"2013","journal-title":"Ultrasound Obstet Gynecol"},{"issue":"11","key":"ref13","doi-asserted-by":"crossref","first-page":"1041","DOI":"10.1007\/s13312-013-0276-9","article-title":"Presence of hernia sac in prediction of postoperative outcome in congenital diaphragmatic hernia","volume":"50","author":"S S Panda","year":"2013","journal-title":"Indian Pediatr"},{"issue":"06","key":"ref14","doi-asserted-by":"crossref","first-page":"1165","DOI":"10.1016\/j.jpedsurg.2013.03.010","article-title":"The presence of a hernia sac in congenital diaphragmatic hernia is associated with better fetal lung growth and outcomes","volume":"48","author":"I J Zamora","year":"2013","journal-title":"J Pediatr Surg"},{"issue":"05","key":"ref15","doi-asserted-by":"crossref","first-page":"1121","DOI":"10.2214\/AJR.15.14476","article-title":"Predictive value of MRI findings for the identification of a hernia sac in fetuses with congenital diaphragmatic hernia","volume":"205","author":"I J Zamora","year":"2015","journal-title":"Am J Roentgenol"},{"issue":"05","key":"ref16","first-page":"515","article-title":"Hernia sac presence portends better survivability of isolated congenital diaphragmatic hernia with \u201cliver-up\u201d","volume":"34","author":"R Grizelj","year":"2017","journal-title":"Am J Perinatol"},{"issue":"09","key":"ref17","doi-asserted-by":"crossref","first-page":"638","DOI":"10.1002\/pd.5326","article-title":"Congenital diaphragmatic hernia has a better prognosis when associated with a hernia sac","volume":"38","author":"H Bouchghoul","year":"2018","journal-title":"Prenat Diagn"},{"issue":"05","key":"ref18","doi-asserted-by":"crossref","first-page":"593","DOI":"10.1007\/s00247-018-04334-9","article-title":"Congenital diaphragmatic hernia sacs: prenatal imaging and associated postnatal outcomes","volume":"49","author":"E R Oliver","year":"2019","journal-title":"Pediatr Radiol"},{"issue":"13","key":"ref19","doi-asserted-by":"crossref","first-page":"1833","DOI":"10.1002\/bjs.9306","article-title":"Outcomes following prosthetic patch repair in newborns with congenital diaphragmatic hernia","volume":"100","author":"W B Jawaid","year":"2013","journal-title":"Br J Surg"},{"issue":"05","key":"ref20","doi-asserted-by":"crossref","first-page":"899","DOI":"10.1016\/j.jpedsurg.2019.01.016","article-title":"The presence of a hernia sac in isolated congenital diaphragmatic hernia is associated with less disease severity: a retrospective cohort study","volume":"54","author":"M Levesque","year":"2019","journal-title":"J Pediatr Surg"},{"issue":"10","key":"ref21","doi-asserted-by":"crossref","first-page":"e71","DOI":"10.1542\/pir.20-10-e71","article-title":"Congenital diaphragmatic hernia: the surgeon's perspective","volume":"20","author":"E D Skarsgard","year":"1999","journal-title":"Pediatr Rev"}],"container-title":["European Journal of Pediatric Surgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0040-1713131.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,5,20]],"date-time":"2021-05-20T22:32:51Z","timestamp":1621549971000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0040-1713131"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,6,11]]},"references-count":21,"journal-issue":{"issue":"03","published-online":{"date-parts":[[2021,5,20]]},"published-print":{"date-parts":[[2021,6]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0040-1713131","relation":{},"ISSN":["0939-7248","1439-359X"],"issn-type":[{"value":"0939-7248","type":"print"},{"value":"1439-359X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,6,11]]}}}