Pediatr Surg Int

. 2024 Jul 3;40(1):171.

 doi: 10.1007/s00383-024-05751-8. https://pubmed.ncbi.nlm.nih.gov/38958763/

Abdominal wall muscle weakness outcomes after split abdominal flap repair of large congenital diaphragmatic hernias in newborn

J Andrés Molino ¹, Gabriela Guillen ², Haider Ali Khan ³, Sergio López Fernández ², Marta Martos Rodríguez ², Oscar Rocha ³, Manuel López Paredes ³

Affiliations expand

• PMID: 38958763
• DOI: 10.1007/s00383-024-05751-8

Abstract

Purpose: Split abdominal wall muscle flap (SAWMF) is a technique to repair large defects in congenital diaphragmatic hernia (CDH). A possible objection to this intervention could be any associated abdominal muscle weakness. Our aim is to analyze the evolution of this abdominal muscle wall weakness.

Methods: Retrospective review of CDH repair by SAWMF (internal oblique muscle and transverse) from 2004 to 2023 focusing on the evolution of muscle wall weakness.

Results: Eighteen neonates of 148 CDH patients (12,1%) were repaired using SAWMF. Mean gestational age and birth weight were 35.7 ± 3.5 weeks and 2587 ± 816 g. Mean lung-to-head ratio was 1.49 ± 0.28 and 78% liver-up. Seven patients (38%) were prenatally treated by tracheal occlusion. Ninety-four percent of the flaps were used for primary repair and one to repair a recurrence. One patient (5.6%) experienced recurrence. Abdominal muscle wall weakness was present in the form of a bulge. Resolution of weakness at 1, 2 and 3 years was 67%, 89% and 94%, respectively. No patient required treatment for weakness or died.

Conclusions: Abdominal muscular weakness after a split abdominal wall muscle flap repair is not a limitation for its realization since it is asymptomatic and presents a prompt spontaneous resolution.

Level of evidence: IV.

Keywords: Abdominal weakness; Congenital diaphragmatic hernia; Newborn; Split abdominal wall muscle flap.

© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.