Our Summary

This research paper is about a study which compared two different surgical techniques for repairing a condition called Congenital Diaphragmatic Hernia (CDH) in kids. This condition is where there’s a hole in the diaphragm (the muscle separating the chest from the abdomen) present from birth. The two techniques compared were the ‘patch’ repair and the ‘flap’ repair.

The study looked at 70 CDH repair operations done at a children’s hospital between 2008 and 2018. They found that the kids’ age, gender, severity of hernia, and other factors were pretty much the same whether they had a patch or a flap repair.

When they looked at the results of the operations, they found that how long the kids stayed in hospital, whether they died within 30 days of the operation or within a year, were also the same for both types of repair. But, when they looked at how many of the hernias came back (recurred), they found that this was more common in the kids who had a patch repair (10% of them) compared to those with a flap repair (3% of them). Also, the hernias tended to come back sooner in the patch repair kids - about 3 months after the operation.

In conclusion, the study suggests that flap repair might be a better option as it has a lower risk of the hernia coming back, possibly because the flap can grow with the child.

FAQs

  1. What is the main difference between patch and flap repair for congenital diaphragmatic hernia?
  2. Is there a difference in recurrence risk between patch and flap repair methods for congenital diaphragmatic hernia?
  3. Are there any differences in length of stay, 30-day mortality, and 1-year mortality between patch and flap repairs for congenital diaphragmatic hernia?

Doctor’s Tip

A helpful tip a doctor might tell a patient about congenital diaphragmatic hernia repair is to consider flap repair over patch repair, as flap repair may have a lower risk of recurrence. It is important to discuss with your healthcare provider the best surgical approach for your specific situation.

Suitable For

Patients with congenital diaphragmatic hernia are typically recommended for repair surgery. In this study, the comparison between patch and flap repair showed that patients who undergo flap repair have a lower risk of recurrence compared to those who undergo patch repair. This finding suggests that flap repair may be a better option for patients with CDH. It is important for healthcare providers to consider the type of repair when planning surgery for patients with congenital diaphragmatic hernia.

Timeline

Before Congenital Diaphragmatic Hernia Repair:

  • Patient is diagnosed with congenital diaphragmatic hernia
  • Patient undergoes preoperative evaluation and preparation
  • Surgery is scheduled and patient is admitted to the hospital

After Congenital Diaphragmatic Hernia Repair:

  • Patient undergoes surgery either with patch or flap repair
  • Patient is closely monitored in the postoperative period for complications
  • Patient typically stays in the hospital for a certain length of time for recovery
  • Patient may experience recurrence of hernia, with a higher risk in those who underwent patch repair
  • Long-term follow-up is necessary to monitor for any complications or recurrence of hernia

What to Ask Your Doctor

  1. What are the different approaches for repairing a congenital diaphragmatic hernia (CDH)?
  2. What are the potential risks and benefits of patch repair versus flap repair for CDH?
  3. How does the length of stay in the hospital compare between patch and flap repair for CDH?
  4. What is the 30-day mortality rate for patients undergoing patch repair versus flap repair for CDH?
  5. What is the 1-year mortality rate for patients undergoing patch repair versus flap repair for CDH?
  6. What is the rate of total or symptomatic recurrence for patients undergoing patch repair versus flap repair for CDH?
  7. How does the median time to recurrence compare between patch and flap repair for CDH?
  8. Are there any factors that may influence the risk of recurrence in patients undergoing CDH repair?
  9. What follow-up care or monitoring is recommended for patients who have undergone CDH repair?
  10. Are there any long-term implications or considerations for patients who have undergone CDH repair, particularly in terms of recurrence?

Reference

Authors: Dewberry L, Hilton S, Gien J, Liechty KW, Marwan AI. Journal: J Pediatr Surg. 2019 Dec;54(12):2487-2491. doi: 10.1016/j.jpedsurg.2019.08.042. Epub 2019 Aug 30. PMID: 31515112