Our Summary

This research aims to understand the long-term health issues in patients who have survived a birth defect called congenital diaphragmatic hernia (CDH), which is a hole in the diaphragm that allows organs from the abdomen to move into the chest. The researchers focused on problems related to the bones and muscles.

They conducted a study of patients who had surgery for CDH between 2003 and 2016, and looked at factors such as the size of the defect in the diaphragm, the type of surgical repair used, and other parameters from the time of birth.

Out of the 98 patients studied, about a third had the diaphragm repaired with their own tissue, a quarter used a patch, and 40% used a flap of muscle. The researchers found that patients with larger defects in the diaphragm were more likely to have certain types of bone and muscle deformities.

However, patients who had smaller defects and were treated with a patch were less likely to have these issues. Patients who had their abdomen closed after a hernia were more likely to have a specific chest deformity called pectus excavatum.

The study did not find a significant link between the use of a muscle flap for repair and the risk of these deformities. Overall, the severity of the CDH was linked to the chance of developing bone and muscle problems.

FAQs

  1. What is the main focus of this research on congenital diaphragmatic hernia (CDH)?
  2. What did the study find about the link between the size of the diaphragm defect and the likelihood of developing bone and muscle deformities?
  3. Was there a significant link found between the use of a muscle flap for repair and the risk of bone and muscle deformities in CDH patients?

Doctor’s Tip

One helpful tip a doctor might tell a patient about congenital diaphragmatic hernia repair is to ensure regular follow-up appointments with a healthcare provider. Monitoring for any potential long-term health issues, such as bone and muscle deformities, can help catch and address any problems early on. Additionally, staying active and maintaining a healthy lifestyle can help prevent or manage any musculoskeletal issues that may arise as a result of CDH repair.

Suitable For

Patients who are typically recommended congenital diaphragmatic hernia repair are those with larger defects in the diaphragm, as they are at a higher risk of developing bone and muscle deformities. Patients with smaller defects may be treated with a patch, which can lower the risk of these issues. Patients who have their abdomen closed after hernia repair may be more likely to develop chest deformities. Overall, the severity of the CDH is a key factor in determining the need for surgical repair and the potential for long-term health issues.

Timeline

Before congenital diaphragmatic hernia repair:

  • Diagnosis of CDH through prenatal ultrasound or after birth
  • Monitoring of the baby’s condition in the neonatal intensive care unit (NICU)
  • Stabilization of the baby’s condition through respiratory support, feeding tubes, and other medical interventions
  • Surgical consultation for repair of the diaphragmatic hernia

After congenital diaphragmatic hernia repair:

  • Recovery period in the hospital with monitoring for complications
  • Follow-up appointments with pediatric specialists to monitor growth and development
  • Potential long-term issues such as bone and muscle deformities, respiratory problems, and gastrointestinal issues
  • Ongoing medical management and support for any related health concerns
  • Regular monitoring and follow-up care to address any potential complications or issues related to the CDH repair.

What to Ask Your Doctor

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

  1. What type of surgical repair was used for my CDH, and why was that specific method chosen?
  2. What was the size of the defect in my diaphragm, and how does that impact my long-term health?
  3. What are the potential risks and complications associated with the type of repair I received?
  4. Are there any specific bone or muscle deformities I should be aware of, given the type of repair I had?
  5. How often should I follow up with a specialist to monitor for any potential long-term health issues related to my CDH repair?
  6. Are there any lifestyle changes or precautions I should take to minimize the risk of developing bone or muscle problems in the future?
  7. Are there any specific symptoms I should watch out for that may indicate a complication related to my CDH repair?
  8. Are there any support groups or resources available for individuals who have undergone CDH repair to connect with others and share experiences?

Reference

Authors: Aydın E, Özler O, Burns P, Lim FY, Peiró JL. Journal: Pediatr Surg Int. 2019 Nov;35(11):1265-1270. doi: 10.1007/s00383-019-04548-4. Epub 2019 Sep 3. PMID: 31482324