Early versus late surgical correction in congenital diaphragmatic hernia.

Autor:	Yunes A; Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile; Proyecto Epistemonikos, Santiago, Chile., Luco M; Proyecto Epistemonikos, Santiago, Chile; Departamento de Neonatología, División de Pediatría, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile. Email: mluco@med.puc.cl. Address:Centro Evidencia UC, Pontificia Universidad Católica de Chile, Centro de Innovación UC Anacleta Angelini, Avda. Vicuña Mackenna 4860, Macul, Santiago, Chile., Pattillo JC; Proyecto Epistemonikos, Santiago, Chile; Sección Cirugía Pediátrica, División de Cirugía, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.
Jazyk:	Spanish; Castilian; English
Zdroj:	Medwave [Medwave] 2017 Nov 15; Vol. 17 (9), pp. e7081. Date of Electronic Publication: 2017 Nov 15.
DOI:	10.5867/medwave.2017.09.7081
Abstrakt:	Introduction: The timing of surgical repair in patients with congenital diaphragmatic hernia has been a controversial topic over the years, and there is still no agreement as to whether immediate repair or late surgery with preoperative stabilization is preferable. Methods: To answer this question we used Epistemonikos, the largest database of systematic reviews in health, which is maintained by screening multiple information sources, including MEDLINE, EMBASE, Cochrane, among others. We extracted data from the systematic reviews, reanalyzed data of primary studies, conducted a meta-analysis and generated a summary of findings table using the GRADE approach. Results and Conclusions: We identified four systematic reviews including 38 studies overall, of which two were randomized trials. We concluded it is not clear whether immediate surgical repair in congenital diaphragmatic hernia increases mortality or decreases hospitalization days compared to late repair because the certainty of evidence is very low.
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu