Pediatr Surg Int

. 2024 Jul 2;40(1):166.

 doi: 10.1007/s00383-024-05739-4. https://pubmed.ncbi.nlm.nih.gov/38954216/

Recurrence of anterior congenital diaphragmatic hernia after laparoscopic repair in children

Mamane Oumarou ¹, Nicoleta Panait ¹, Eliane El Khoury ¹, Zeinab Hamidou ², Jessica Pinol ¹, Patricia Barila Lompe ¹, Thierry Merrot ¹, Alice Faure ¹, Anne Dariel ³

Affiliations expand

• PMID: 38954216
• DOI: 10.1007/s00383-024-05739-4

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.

Keywords: Anterior congenital diaphragmatic hernia; Children; Laparoscopy; Minimally invasive surgery; Morgagni hernia; Recurrence.

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