Our Summary

The research paper investigates the treatment of diaphragmatic hernia (DH), a rare but potentially serious condition where a hole in the diaphragm allows organs to move from the abdomen into the chest. Since there are no set guidelines for treating DH, the researchers look at past cases and treatment methods at their medical institution from 2009 to 2019.

They found that 15 patients with DH were treated surgically during this period, 5 of which were born with the condition, and the rest developed it due to injuries. In some cases, immediate surgery was required, while in others, it could be scheduled for a later time. Different surgical methods were used, including closing the hole in the diaphragm, reinforcing it with a mesh, or just placing a mesh.

The researchers suggest that laparoscopic surgery (a minimally invasive procedure using small incisions) could be the first choice when the surgery isn’t urgent, and sometimes even in emergencies, depending on the patient’s condition and associated injuries. The post-surgery complications were relatively low, there were no deaths, and the hernia did not reoccur in any of the patients.

FAQs

  1. What is a diaphragmatic hernia and how serious is it?
  2. What were some of the surgical methods used in treating diaphragmatic hernia as found in the study?
  3. Why do the researchers suggest laparoscopic surgery as the first choice for non-urgent cases of diaphragmatic hernia?

Doctor’s Tip

One helpful tip a doctor might tell a patient about congenital diaphragmatic hernia repair is to follow all post-operative care instructions carefully, including taking prescribed medications, avoiding strenuous activities, and attending follow-up appointments. It is important to communicate any new or worsening symptoms to your healthcare provider promptly.

Suitable For

Patients who are typically recommended congenital diaphragmatic hernia repair are those who are born with the condition or develop it due to injuries. In some cases, immediate surgery may be required, while in others, it can be scheduled for a later time. The choice of surgical method may vary, including closing the hole in the diaphragm, reinforcing it with a mesh, or just placing a mesh. Laparoscopic surgery may be preferred in non-urgent cases, depending on the patient’s condition and associated injuries. The post-surgery complications were relatively low in the cases studied, with no deaths and no hernia recurrence.

Timeline

Overall, the timeline of a patient with congenital diaphragmatic hernia before and after repair may look something like this:

Before surgery:

  • Diagnosis of congenital diaphragmatic hernia, either prenatally or shortly after birth
  • Monitoring of the patient’s condition and potential complications
  • Evaluation of the need for surgery and scheduling of the procedure
  • Preparation for surgery, which may include tests, consultations with specialists, and discussions with the medical team

During surgery:

  • Surgical repair of the diaphragmatic hernia using various techniques
  • Monitoring of the patient’s condition during and after the procedure
  • Potential complications during surgery, such as bleeding or damage to surrounding organs

After surgery:

  • Recovery in the hospital, which may include monitoring of vital signs, pain management, and rehabilitation
  • Follow-up appointments with the medical team to monitor the patient’s progress and address any concerns
  • Long-term follow-up to monitor for any potential complications or recurrence of the hernia

Overall, the goal of surgery for congenital diaphragmatic hernia is to repair the hole in the diaphragm and allow the organs to return to their proper place in the abdomen. With proper treatment and follow-up care, most patients can recover well and lead a normal life.

What to Ask Your Doctor

  1. What are the potential risks and benefits of surgical repair for congenital diaphragmatic hernia?
  2. Are there any non-surgical treatment options available for congenital diaphragmatic hernia?
  3. How long is the recovery process after surgery for congenital diaphragmatic hernia repair?
  4. Will there be any long-term effects or complications after surgery for congenital diaphragmatic hernia?
  5. What is the success rate of surgical repair for congenital diaphragmatic hernia at your medical institution?
  6. How often will follow-up appointments be needed after surgery for congenital diaphragmatic hernia repair?
  7. Are there any lifestyle changes or restrictions that need to be followed after surgery for congenital diaphragmatic hernia repair?
  8. What signs or symptoms should I watch out for that may indicate a recurrence of the hernia after surgery?
  9. Are there any specific dietary recommendations that should be followed after surgery for congenital diaphragmatic hernia repair?
  10. Are there any support groups or resources available for patients who have undergone surgery for congenital diaphragmatic hernia repair?

Reference

Authors: Fernández-Moreno MC, Barrios Carvajal ME, López Mozos F, Garcés Albir M, Martí Obiol R, Ortega J. Journal: Surg Endosc. 2022 May;36(5):3347-3355. doi: 10.1007/s00464-021-08651-3. Epub 2021 Jul 26. PMID: 34312729