Comparison of recurrence after diaphragmatic hernioplasties with direct closure versus patch placement
DOI:
https://doi.org/10.51481/amc.v62i3.1073Keywords:
Goretex patch, direct closure, congenital diaphragmatic herniaAbstract
Objective: to investigate with which surgical technique, direct closure or use of a Goretex patch, congenital diaphragmatic hernias recurre more.
Methodology: the data of the patients who underwent repair of congenital diaphragmatic hernia at the National Children's Hospital from January 2008 to December 31, 2017, were reviewed retrospectively. Of the 94 patients, only 59 met the inclusion criteria. For the comparison of the quantitative variables, Student's t-test and 95% confidence intervals were used, the qualitative variables were analyzed by the Fisher's test with a significance level of 0.05
Results: Most of the operated diaphragmatic hernias were left 78% and posterolateral 91%. The most frequent repair technique used was direct closure, 68%. There were more recurrences after closing when a Goretex patch was used. They occurred between 1 and 12 months post-operatively. There was no statistically significant difference between recurrences with the direct closure technique versus closure with the Goretex patch.
Conclusion: Performing a direct closure of the diaphragm is a good surgical option for surgical repair of congenital diaphragmatic hernias. There were no statistically significant differences in relapse in this study between using the direct closure or patch technique
Downloads
References
Lally K. Congenital diaphragmatic hernia - the past 25 (or so) years. J Pediatr Surg. 2016;51:695-698
Lally K, Lasky RE, Lally PA, Bagolan P, Davis DF, Frenckner BP, et al. Standardized reporting for congenital diaphragmatic hernia - An international consensus. J Pediatr Surg. 2013;48: 2408-2415
Tsao K, Lally PA, Lally KP, Congenital Diaphragmatic Hernia Study Group. Minimally invasive repair of congenital diaphragmatic hernia. J Pediatr Surg. 2011; 46: 1158-1164
Antiel R, Riley JS, Cahill PJ, Campbell RM, Waqar L, Herkert LM, et al. Management and outcomes of scoliosis in children with congenital diaphragmatic hernia. J Pediatr Surg. 2016; 51:1921-1925.
Bekdash B, Singh B, Lakhoo K. Recurrent late complications following congenital diaphragmatic hernia repair with prosthetic patches: a case series J Med Case Rep. 2009; 3:7237.
Okazaki T, Hasegawa S, Urushihara N, Fukumoto K, Ogura K, Minato S, et al. Toldt's fascia flap: a new technique for repairing large diaphragmatic hernias. Pediatr Surg Int. 2005; 21: 64-67.
Tsang TM, Tam PK, Dudley NE, Stevens J. Diaphragmatic agenesis as a distinct clinical entity. J Pediatr Surg. 1994;29:1439-1441.
Moss RL, Chen CM, Harrison MR. Prosthetic patch durability in congenital diaphragmatic a long-term follow-up study. J Pediatr Surg. 2001;36:152-154.
Sánchez, M. Hernia diafragmática congénita: predictor postnatal, análisis retrospectivo de su evolución. Hospital Nacional de Niños. 2003-2010. Tesis de graduación, CCSS
Rodríguez, R Jonathan. Análisis epidemiológico de los recién nacidos vivos con hernia diafragmática congénita ingresados al Hospital Nacional de Niños ""Dr. Carlos Sáenz Herrera"" del año 2008 al 2015. Tesis de graduación, CCSS, Hospital Nacional de Niños
Stolar CJH, Dillon PW. Congenital diaphragmatic hernia and eventration. Chapter 60. In: Grosfeld J, O'Neill J, Coran A, eds, et al. Pediatric surgery. 6th edn.
Putnam L, Gubpta V, Tsao K, Davis KF, Lally PA, Lally KP, et al. Factors associated with early recurrence after congenital diaphragmatic hernia repair. J Pediatr Surg. 2017;52:928-932.
Tsao K, Lally KP. Surgical management of the newborn with congenital diaphragmatic hernia. Fetal Diagn Ther. 2011;29:46-54.
Smith MJ, Paran TS, Quinn F, Corbally MT. The SIS extracellular matrix scaffold—preliminary results of use in congenital diaphragmatic hernia (CDH) repair. Pediatr Surg Int. 2004; 20: 859-862.
Riehle KJ, Magnuson DK, Waldhausen JH. Low recurrence rate after Gore-Tex/Marlex composite patch repair for posterolateral congenital diaphragmatic hernia. J Pediatr Surg. 2007; 42:1841-1844
Downloads
Published
Issue
Section
License
Copyright (c) 2020 Acta Médica Costarricense
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Los autores que publican en la revista Acta Médica Costarricense pueden distribuir, copiar, remezclar, retocar, leer, descargar, imprimir, buscar y crear a partir de su obra de modo no comercial, indicando los créditos a la revista y sus autores y compartir su obra en las mismas condiciones. Para ello se aplica la licencia Creative Commons Reconocimiento-NoComercial-CompartirIgual 4.0 Internacional(CC BY-NC-SA 4.0)
