Our Summary

This research paper looks at the results of using two kinds of patches – small intestinal submucosal (SIS) and polytetrafluoroethylene (PTFE) – to repair large congenital diaphragmatic hernias (CDH), a birth defect that causes a hole in the diaphragm.

The researchers reviewed data collected from 2011 to 2019 on patients who had undergone CDH repair, looking at factors such as how long the patients stayed in the hospital, whether they survived, and whether the hernia returned.

Out of 195 patients with CDH, 176 had surgery to repair the hernia while 19 passed away before they could have the operation. A total of 62 patients needed a patch for the repair. Over the five-year study period, the hospital transitioned from using only SIS patches to using only PTFE patches.

The researchers found that there was no significant difference in the length of hospital stay and survival rate between the two types of patches. However, they did find that the hernia was more likely to come back in patients who received the SIS patch. Half of the patients who had an SIS patch had a recurrence, compared to just 4% of patients with a PTFE patch.

In conclusion, the researchers found that PTFE patches were more effective at preventing a recurrence of the hernia than SIS patches.

FAQs

  1. What are the two types of patches used in the study for congenital diaphragmatic hernia repair?
  2. Was there any significant difference in the length of hospital stay and survival rate between patients who received SIS patches and those who received PTFE patches?
  3. Which patch was found to be more effective at preventing a recurrence of the hernia?

Doctor’s Tip

A helpful tip a doctor might tell a patient about congenital diaphragmatic hernia repair is to discuss with their healthcare provider the type of patch that will be used for the repair. Based on this research, it appears that PTFE patches may be more effective at preventing the hernia from recurring compared to SIS patches. It is important to have an open dialogue with the healthcare team to ensure the best possible outcome for the patient.

Suitable For

Patients with large congenital diaphragmatic hernias are typically recommended to undergo repair surgery, especially if they are experiencing symptoms such as difficulty breathing, feeding problems, or failure to thrive. Additionally, patients who have a high risk of complications from the hernia, such as those with severe respiratory distress or compromised lung function, may also be recommended for surgery.

Timeline

Before congenital diaphragmatic hernia repair:

  • Patient is diagnosed with CDH through prenatal ultrasound or after birth
  • Patient may experience symptoms such as difficulty breathing, rapid breathing, and cyanosis (bluish skin color)
  • Patient may undergo various tests and evaluations to determine the severity of the hernia
  • Surgery is scheduled to repair the hernia, which may involve the use of a patch

After congenital diaphragmatic hernia repair:

  • Patient undergoes surgery to repair the hernia, which may involve the use of a small intestinal submucosal (SIS) or polytetrafluoroethylene (PTFE) patch
  • Patient recovers in the hospital for a certain period of time, depending on the complexity of the surgery and the patient’s overall health
  • Patient is monitored for any signs of hernia recurrence or complications
  • Patient may undergo follow-up appointments and tests to ensure the success of the surgery and monitor long-term outcomes.

What to Ask Your Doctor

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

  1. What are the different types of patches that can be used for CDH repair, and what are the benefits and risks associated with each?
  2. What factors will determine whether I need a patch for my CDH repair?
  3. What is the expected length of hospital stay and recovery time after CDH repair surgery?
  4. What is the success rate of CDH repair surgery in preventing a hernia recurrence?
  5. What are the potential complications or side effects of CDH repair surgery?
  6. Are there any long-term effects or considerations I should be aware of after CDH repair surgery?
  7. How often will I need follow-up appointments or monitoring after CDH repair surgery?
  8. Are there any lifestyle changes or precautions I should take after CDH repair surgery to prevent a recurrence?
  9. What is the experience and success rate of the surgical team in performing CDH repair surgeries?
  10. Are there any alternative treatment options or additional resources available for CDH management?

Reference

Authors: Ruhrnschopf CG, Reusmann A, Boglione M, Arbio S, Salas G, Giubergia V, Barrenechea M. Journal: J Pediatr Surg. 2021 Nov;56(11):1957-1961. doi: 10.1016/j.jpedsurg.2021.02.052. Epub 2021 Feb 25. PMID: 33745743