Our Summary

This study examined 203 patients born with congenital diaphragmatic hernia (CDH), a birth defect where a hole in the diaphragm allows organs to move into the chest, which can cause breathing problems. These patients had their CDH repaired between 2000 and 2016, and the researchers were checking to see how many had their hernia return after surgery. They focused on whether a patch was used to close the hole in the diaphragm and whether the surgery was done through thoracoscopy (a minimally invasive procedure using a tube inserted through a small incision) or open surgery. They discovered that the method of surgery mattered more than whether a patch was used, with thoracoscopy having a higher rate of hernia recurrence than open surgery. However, the use of a patch was not associated with a higher chance of the hernia returning.

FAQs

  1. What is congenital diaphragmatic hernia (CDH) and how does it affect patients?
  2. Does the method of surgery affect the recurrence rate of CDH?
  3. Is the use of a patch associated with a higher chance of hernia recurrence after CDH repair?

Doctor’s Tip

A helpful tip a doctor might give a patient about congenital diaphragmatic hernia repair is to discuss the best surgical approach with their healthcare provider. It’s important to understand the risks and benefits of both thoracoscopy and open surgery, as well as whether a patch will be used during the repair. Patients should also follow their doctor’s post-operative instructions carefully to ensure a successful recovery and lower the risk of hernia recurrence.

Suitable For

Patients with congenital diaphragmatic hernia are typically recommended to undergo surgical repair if they are experiencing significant breathing difficulties or if their hernia is causing other complications. The decision to recommend surgery may also depend on the size and location of the hernia, as well as the overall health and age of the patient. In some cases, surgery may be recommended shortly after birth, while in other cases it may be delayed until the patient is older and better able to tolerate the procedure.

Timeline

Before CDH repair:

  • Patient is born with a hole in the diaphragm, allowing organs to move into the chest
  • Patient may experience breathing difficulties, feeding problems, and other symptoms associated with CDH
  • Doctors diagnose CDH and discuss treatment options with the patient’s family

After CDH repair:

  • Patient undergoes surgery to repair the hole in the diaphragm
  • Depending on the method of surgery (thoracoscopy or open surgery) and whether a patch is used, the patient may have different outcomes
  • In the study mentioned, patients who underwent thoracoscopy had a higher rate of hernia recurrence compared to open surgery, but the use of a patch did not affect the likelihood of the hernia returning
  • Patient receives follow-up care to monitor for any complications or recurrence of the hernia

What to Ask Your Doctor

  1. What is the likelihood of my congenital diaphragmatic hernia returning after surgery?
  2. What are the potential risks and complications associated with the different surgical approaches (thoracoscopy vs. open surgery)?
  3. How experienced is the medical team in performing congenital diaphragmatic hernia repair surgery?
  4. What is the recovery process like following congenital diaphragmatic hernia repair surgery?
  5. Are there any long-term effects or complications I should be aware of after surgery?
  6. What is the expected outcome and prognosis for my specific case of congenital diaphragmatic hernia?
  7. Will I need any additional follow-up appointments or tests after surgery?
  8. Are there any lifestyle changes or restrictions I should consider after surgery?
  9. What are my options if my congenital diaphragmatic hernia were to return after surgery?
  10. Are there any alternative treatments or therapies available for congenital diaphragmatic hernia repair?

Reference

Authors: Suply E, Rees C, Cross K, Elagami H, Blackburn S, Giuliani S, D’Souza R, David AL, Deprest J, Curry J, Eaton S, De Coppi P. Journal: J Pediatr Surg. 2020 Aug;55(8):1522-1527. doi: 10.1016/j.jpedsurg.2019.10.021. Epub 2019 Nov 1. PMID: 31711747