Our Summary

The research paper discusses a study on the surgical treatment of a rare condition in adults called congenital diaphragmatic hernias (CDHs), where a hole in the diaphragm present from birth allows organs to move into the chest. This can cause problems with breathing and digestion and can even lead to life-threatening bowel strangulation. The researchers looked at the results of surgeries performed on adults with this condition between 2010 and 2019 at one hospital.

They found 37 patients to study (mostly women, with an average age of 57). Most of these patients had minimally invasive surgeries, and about a third were emergency surgeries. About 1 in 5 patients had complications after surgery, but none of them died within 90 days of their operation, and there were no cases of the hernia coming back in either the short or long term.

Patients who had minimally invasive surgeries (laparoscopy) had a shorter hospital stay compared to those who had traditional open surgery. This suggests that laparoscopic repair for CDHs is safe and effective, with fewer complications and shorter hospital stays.

FAQs

  1. What is a congenital diaphragmatic hernia and what problems can it cause?
  2. What does the study suggest about the effectiveness of laparoscopic repair for congenital diaphragmatic hernias?
  3. What was the rate of complications and recurrence after surgery for congenital diaphragmatic hernias based on this study?

Doctor’s Tip

One helpful tip a doctor might tell a patient about congenital diaphragmatic hernia repair is to discuss the option of minimally invasive surgery, such as laparoscopy, as it can lead to shorter hospital stays and potentially fewer complications compared to traditional open surgery.

Suitable For

Patients with congenital diaphragmatic hernias (CDHs) are typically recommended for repair surgery if they are experiencing symptoms such as difficulty breathing, chest pain, abdominal discomfort, or digestive issues. In some cases, CDH repair may be recommended as a preventive measure to avoid potential complications such as bowel strangulation.

The study mentioned above focused on adult patients with CDHs, but CDH repair is also commonly performed in infants and children with the condition. In pediatric patients, CDH repair is often recommended shortly after birth or in early childhood to prevent complications and improve long-term outcomes.

Overall, patients recommended for CDH repair surgery are those who are experiencing symptoms related to their condition or who are at risk for potential complications. The decision to undergo CDH repair surgery is typically made based on the individual patient’s medical history, symptoms, and overall health status.

Timeline

Before congenital diaphragmatic hernia repair:

  • Patient may experience symptoms such as difficulty breathing, chest pain, and digestive issues
  • Diagnosis of CDH is made through imaging tests such as X-rays or CT scans
  • Patient may undergo preoperative tests and evaluations to assess their overall health and readiness for surgery

After congenital diaphragmatic hernia repair:

  • Patient undergoes surgical repair of the diaphragmatic hernia, either through minimally invasive laparoscopic surgery or traditional open surgery
  • Patient may experience some pain and discomfort after surgery, which is managed with pain medication
  • Patient is monitored closely for any complications such as infection or recurrence of the hernia
  • Patient is discharged from the hospital once they are stable and able to resume normal activities
  • Patient may undergo follow-up appointments to ensure proper healing and long-term success of the surgery.

What to Ask Your Doctor

Some questions a patient should ask their doctor about congenital diaphragmatic hernia repair include:

  1. What are the risks and benefits of surgery for congenital diaphragmatic hernia repair?
  2. How experienced are you in performing minimally invasive surgery for this condition?
  3. What is the expected recovery time after surgery?
  4. Are there any specific lifestyle changes I should make after surgery to prevent the hernia from coming back?
  5. What symptoms should I watch out for that may indicate a complication after surgery?
  6. Will I need any follow-up appointments or tests after surgery?
  7. Are there any alternative treatment options for my condition?
  8. How likely is it that the hernia will come back after surgery?
  9. Are there any long-term effects or complications I should be aware of after surgery?
  10. How can I best prepare for surgery and optimize my recovery outcomes?

Reference

Authors: Hietaniemi H, Järvinen T, Ilonen I, Räsänen J. Journal: Scand J Gastroenterol. 2022 Nov;57(11):1291-1295. doi: 10.1080/00365521.2022.2081818. Epub 2022 Jun 4. PMID: 35658774