From March 1990 to July 2006, we admitted 33 newborn patients with CDH. Twenty-six patients (79 % ) (male 13, left-sided 21) survived. Extracorporeal membrane oxygenation was required in one patient and patch closure in 10 patients. The follow-up consisted of assessment of GER symptoms at 6 months, 1 year, 3 years, 5 years, and 10 years; endoscopy; and pH-metry for all patients at 1 year and to selected patients (with symptoms or complications of GER) from 3 to 10 years after the primary closure of CDH. Gastroesophageal reflux was considered significant (sGER) when a symptomatic patient required ARS, had endoscopic biopsies showing at least moderate esophagitis, or total and preprandial reflux index of more than 10 % and 5 % , respectively.
The incidence of sGER (patients with sGER/total amount assessed) at 6 months, 1 year, 3 years, 5 years, and 10 years was 27 % (7/26), 42 % (11/26), 53 % (8/15), 53 % (8/15), and 55 % (5/9), respectively. During a median follow-up of 60 months (range, 12-195 months), 12 (46 % ) of 26 patients had sGER and 4 (15 % ) required ARS. After the assessment at 1 year, only one new case of sGER appeared. Endoscopic and/or pH-metric assessment covered 100 % of the patients at 1 year follow-up, but later on only 70 % .
One year after the primary closure of CDH, the incidence of sGER was 42 % . After 1 year follow-up, only one new case of sGER was found, and ARS was not required. In patients who required ARS manifested before 6 months.