Abstract
Large studies comparing the surgical outcome of primary versus patch repair in congenital diaphragmatic hernia (CDH) patients are rare. This study aims to evaluate the incidence of surgical complications in both types of CDH repair. PubMed, EMBASE, Cochrane and Web of Science were searched for peer-reviewed articles. Studies on CDH between 1991 and August 2020 were systematically screened and meta-analyses were performed. Primary outcomes of this review were: haemorrhage, chylothorax, recurrences and small bowel obstruction (SBO). A total of 6436 abstracts were screened, after which 25 publications were included (2910 patients). Patch repaired patients have a 2.8 times higher risk on developing a recurrence (20 studies) and a 2.5 times higher risk on developing a chylothorax (five studies). Moreover, they have a two times higher risk on developing a SBO. No studies could be included that evaluated the incidence of surgical haemorrhage between these patients. Although the quality of the studies was relatively low, patch repaired patients have a higher risk on developing a recurrence, chylothorax and small bowel obstruction. Large prospective studies are required to adjust for severity of disease, to reveal the true causative factors in order to minimize the risk on these surgical complications in both types of patients.
Highlights
Large studies comparing the surgical outcome of primary versus patch repair in congenital diaphragmatic hernia (CDH) patients are rare
The search terms used were based on the subject (‘’congenital diaphragmatic hernia’’) and procedure (‘’patch repair’’ and ‘’primary repair’’)
This systematic review reports on the difference in rate of surgical complications, including chylothorax, recurrence and small bowel obstruction (SBO) for primary versus patch repaired CDH patients
Summary
Large studies comparing the surgical outcome of primary versus patch repair in congenital diaphragmatic hernia (CDH) patients are rare. Surgical repair of CDH is required in order to relocate the herniated organs from the thoracic cavity to the abdomen and close the diaphragmatic defect. This repair is mostly performed by an open procedure, while there is ongoing discussion concerning the advantages and disadvantages of minimally invasive surgery[1]. Because there is a lack of prospective and large studies on type of repair, this article provides a systematic review and meta-analysis to evaluate current evidence on the challenging topic of type of repair in CDH and the concurrent risk on surgical complications
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