C.A. Laituri C.L. Garey P.A. Valusek Outcome of congenital diaphragmatic hernia repair depending on patch type Eur J Pediatr Surg 20 6 2010

Abstract

Patch repair of a congenital diaphragmatic hernia (CDH) is associated with a much higher rate of recurrence than after primary repair. The biosynthetic options for the repair materials continue to expand. The authors therefore reviewed their experience to benchmark complication rates as they progress with the use of new materials. A retrospective review was conducted of all patients who underwent repair of CDH. Of the 155 patients included in the study, 101 had primary closure and 54 received a diaphragmatic patch. The rates of recurrence, small bowel obstruction (SBO), and subsequent abdominal operations were all significantly higher in the group of patients requiring patch repair. There were 3 types of patch repair: 37 patients received a small intestinal submucosa (SIS) patch, 12 had a nonabsorbable patch, and 5 received an AlloDerm patch. The incidence of SBO in patients with a nonabsorbable mesh was 17% and associated with 50% recurrence rate and 67% re-recurrence rate. Small intestinal submucosa was associated with a 19% incidence of SBO, a recurrence rate of 22%, and 50% re-recurrence rate; AlloDerm had a 40% incidence of SBO, a 40% recurrence rate, and a 100% re-recurrence rate.