When primary repair is not enough: a comparison of synthetic patch and muscle flap closure in congenital diaphragmatic hernia?

Pediatric Surgery International
Emrah AydınFoong-Yen Lim

Abstract

Primary closure is often inadequate for large congenital diaphragmatic hernia (CDH) and necessitates repair by prosthetic patch or autologous muscle flap. Our aim was to evaluate outcomes of open patch versus flap repair, specifically diaphragmatic reherniation. A retrospective review (IRB #2017-6361) was performed on all CDH patients repaired from 2005 to 2016 at a single academic children's hospital. Patients were excluded from final analysis if they had primary or minimally invasive repair, expired, or were lost to follow-up. Of 171 patients, 151 (88.3%) survived to discharge, 9 expired after discharge and 11 were lost to follow up, leaving 131 (86.8%) long-term survivors. Median follow-up was 5 years. Open repair was performed in 119 (90.8%) of which 28 (23.5%) underwent primary repair, 34 (28.6%) patch repair, and 57 (47.9%) flap repair. Overall, 6/119 (5%) patients reherniated, 1/28 (3.6%) in the primary group, 3/34 (8.8%) in the patch group, and 2/57 (3.5%) in the flap group. Comparing prosthetic patch to muscle flap repair, there was no significant difference in the number of patients who recurred nor time to reherniation (3 vs. 2, p = 0.295; 5.5 ± 0.00 months vs. 53.75 ± 71.06 months, p = 0.288). One patient in the pat...Continue Reading

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May 20, 2019·Journal of Pediatric Surgery·Heather NolanFoong-Yen Lim
Sep 5, 2019·Pediatric Surgery International·Emrah AydınJose Luis Peiró

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Citations

Sep 23, 2020·Journal of Laparoendoscopic & Advanced Surgical Techniques. Part a·Cristobal AbelloJose L Peiro
Dec 29, 2020·The Journal of Surgical Research·Emrah AydınElif Gökçen Bozkurt
Mar 23, 2021·Journal of Pediatric Surgery·Camila Gonzalez RuhrnschopfMarcelo Barrenechea

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