Recurrence of anterior congenital diaphragmatic hernia after laparoscopic repair in children.
Pediatr Surg Int
; 40(1): 166, 2024 Jul 02.
Article
in En
| MEDLINE
| ID: mdl-38954216
ABSTRACT
PURPOSE:
To report our experience with laparoscopic repair of anterior congenital diaphragmatic hernia (CDH) using extracorporeal subcutaneous knot tying and to define recurrence risk factors.METHODS:
This retrospective unicentric study included children who underwent laparoscopic repair of anterior CDH without patch, using extracorporeal knot tying of sutures passed through the full thickness of the abdominal wall (2013-2020). A systematic review of the literature with meta-analysis was performed using the MEDLINE database since 2000.RESULTS:
Eight children were included (12 months [1-183]; 10.6 kg [3.6-65]). Among the two patients with Down syndrome, one with previous cardiac surgery had a recurrence at 17 months postoperatively. In our systematic review (26 articles), among the 156 patients included, 10 had a recurrence (none with patch). Recurrence was statistically more frequent in patients with Down syndrome (19.4%) than without (2.5%) (p < 0.0001), and when absorbable sutures were used (50%) instead of non-absorbable sutures (5.3%) (p < 0.0001).CONCLUSION:
Laparoscopic repair of anterior CDH without patch was a safe and efficient surgical approach in our patients. The use of a non-absorbable prosthetic patch should be specifically discussed in anterior CDH associated with Down syndrome and/or in case of previous cardiac surgery to perform a diaphragmatic tension-free closure.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Recurrence
/
Laparoscopy
/
Herniorrhaphy
/
Hernias, Diaphragmatic, Congenital
Limits:
Adolescent
/
Child
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Child, preschool
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Female
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Humans
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Infant
/
Male
/
Newborn
Language:
En
Journal:
Pediatr Surg Int
Journal subject:
PEDIATRIA
Year:
2024
Document type:
Article
Affiliation country:
Country of publication: