Recurrent congenital diaphragmatic hernia: A single center experience

Submitted: 4 March 2020
Accepted: 11 February 2021
Published: 22 February 2021
Abstract Views: 6493
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Congenital Diaphragmatic Hernia (CDH) occurs in 1:4000 live births. It’s morbidity and mortality rates are significant. Recurrence is one of the recognized complications occurring after a successful initial repair. Poorly known are the rate of recurrence and factors that may influence the re-herniation. Poorly described are its morphology and treatment. Medical records of 95 neonates with CDH who had undergone repair at tertiary pediatric teaching hospital between 2007-2018 were retrospectively reviewed. Prior to surgery, peri-operative and recurrence data were collected. The follow-up was 1 to 12 years after the initial repair. Recurrence occurred in 22/84 (26%) patients. In 5 patients we observed more than one recurrence, total number of 27 (32%) re-herniations; 16/22 (72%) recurrences occurred within first 12 months; 7/27 (26%) recurrences were symptomatic which gives the symptomatic recurrence rate 8.3%; 20/27 (74%) were asymptomatic. There were no significant differences between groups considering LHR, gestational age, birth weight, severity of pre-surgery and post-surgery stabilization period. Significantly higher Apgar scores were in the group without recurrence. Among subjects with recurrent CDH majority had a left-sided defect, no hernia sac, no liver herniation, diaphragm was primarily sutured, abdominal wall primarily closed. Even though none of those factors was significantly related with the recurrence. Recurrence in CDH remains a significant issue for long-term surgical morbidity, especially more apparent in the first year of life. As long as the risk factors of re-herniation remains unclear, the most important seems to be routine follow-up protocol allowing for CDH recurrence detection.

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Citations

Al-lede MM, Karpelowsky J, Fitzgerald DA. Recurrent Diaphragmatic Hernia: Modifiable and Non-Modifable Risk Factors. Ped Pulmonology 2016;51:394-401. DOI: https://doi.org/10.1002/ppul.23305
Rowe DH, Stolar CJ. Recurrent diaphragmatic hernia. Semin Ped Surg 2003;12:107-9. DOI: https://doi.org/10.1016/S1055-8586(02)00020-3
Janssen S, Hewegen K, van Rooij IA, et al. Factors related to long-term surgical morbidity in congenital diaphragmatic hernia survivors. J Ped Surg 2018;53:508-12. DOI: https://doi.org/10.1016/j.jpedsurg.2017.05.032
Jancelewicz T, Chiang M, Oliveira C, Chiu PP. Late surgical outcomes among congenital diaphragmatic hernia (CDH) patients: why long-term follow-up with surgeons is recommended. J Ped Surg 2013;48:935-41. DOI: https://doi.org/10.1016/j.jpedsurg.2013.02.005
Fisher JC, Haley MJ, Ruiz-Elizalde A, et al. A multivariate model for predicting recurrence in congenital diaphragmatic hernia. J Ped Surg 2009;44:1173-80. DOI: https://doi.org/10.1016/j.jpedsurg.2009.02.043
Moss RL, Chen CM, Harrison MR. Prosthetic patch durability in congenital diaphragmatic hernia: a long-term follow-up study. J Ped Surg 2001;36:152-4. DOI: https://doi.org/10.1053/jpsu.2001.20037
Putman LR, Gupta V, Tsao K, et al. Factors associated with early recurrence after congenital diaphragmatic hernia repair. J Ped Surg 2017;52:928-32. DOI: https://doi.org/10.1016/j.jpedsurg.2017.03.011
Nagata K, Usui N, Terui K, et al. Risk Factors for the Recurrence of the Congenital Diaphragmatic Hernia-Report from Long-Term Follow-Up Study of Japanese CDH Study Group. Eur J Ped Surg 2015;25:9-14. DOI: https://doi.org/10.1055/s-0034-1395486
Hayward ML, Fauza DO, Wilson JM. Complications of CDH Repair and Recurrent CDH. In: Teich S, Caniano DA (eds). Reoperative Pediatric Surgery. Humana Press; 2008.
Short HL, Clifton MS, Arps K, et al. The “Flat Diaphragmâ€:Does the Degree of Curvature of the Diaphragm on Postoperative X-Ray Predict Congenital Diaphragmatic Hernia Recurrence? J Laparoendoscopic Advanced Surg Tech 2017;28:476-80. DOI: https://doi.org/10.1089/lap.2017.0228
Hajer GF, vd Staak FH, de Haan AF, Festen C. Reccurent congenital diaphragmatic hernia: which factors are involved? Eur J Ped Surg 1998;8:329-33. DOI: https://doi.org/10.1055/s-2008-1071226
Brindle ME, Brar M, Skarsgard ED. Patch repair is an independent predictor of morbidity and mortality in congenital diaphragmatic hernia. Ped Surg Int 2011;27:969-74. DOI: https://doi.org/10.1007/s00383-011-2925-1
Khoshchehreh M, Paknejad O, Bakhshayesh-Karam M, Pazoki M. Thoracic Kidney: Extremely Rare State of Aberrant Kidney. Case Rep Urol 2015:672628. DOI: https://doi.org/10.1155/2015/672628
Sarac M, Bakal U, Tartar T, et al. Bochdalek hernia and intrathoracic ectopic kidney: Presentation of two case reports and review of the literature. Niger J Clin Pract 2018;21:681-6. DOI: https://doi.org/10.4103/njcp.njcp_217_17

How to Cite

Słowik-Moczydłowska, Żaneta ., & Kamiński, A. (2021). Recurrent congenital diaphragmatic hernia: A single center experience. La Pediatria Medica E Chirurgica, 43(1). https://doi.org/10.4081/pmc.2021.228

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