Long-term outcomes after muscle flap repair in congenital diaphragmatic hernia: A retrospective study at a single institution.
| Title: | Long-term outcomes after muscle flap repair in congenital diaphragmatic hernia: A retrospective study at a single institution. |
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| Authors: | Kahan AM; University of Utah, Department of Surgery, Division of Pediatric Surgery, Salt Lake City, UT, USA. Electronic address: Sasha.kahan@hsc.utah.edu.; Glasgow SL; University of Utah, Department of Surgery, Division of Pediatric Surgery, Salt Lake City, UT, USA.; Yoder BA; University of Utah, Department of Pediatrics, Division of Neonatology, Salt Lake City, UT, USA.; Yang M; University of Utah, Department of Pediatrics, Division of Neonatology, Salt Lake City, UT, USA.; Yost CC; University of Utah, Department of Pediatrics, Division of Neonatology, Salt Lake City, UT, USA; University of Utah, Molecular Medicine Program, Salt Lake City, UT, USA.; Peterson K; University of Utah, Department of Surgery, Division of Pediatric Surgery, Salt Lake City, UT, USA.; Scaife JH; University of Utah, Department of Surgery, Division of Pediatric Surgery, Salt Lake City, UT, USA.; Clinker CE; University of Utah, Department of Surgery, Division of Pediatric Surgery, Salt Lake City, UT, USA.; Arnold E; University of Utah, Department of Surgery, Division of Pediatric Surgery, Salt Lake City, UT, USA.; Fenton SJ; University of Utah, Department of Surgery, Division of Pediatric Surgery, Salt Lake City, UT, USA.; Kastenberg ZJ; University of Utah, Department of Surgery, Division of Pediatric Surgery, Salt Lake City, UT, USA.; Swendiman RA; University of Utah, Department of Surgery, Division of Pediatric Surgery, Salt Lake City, UT, USA.; Russell KW; University of Utah, Department of Surgery, Division of Pediatric Surgery, Salt Lake City, UT, USA. |
| Source: | Journal of pediatric surgery [J Pediatr Surg] 2026 Jan; Vol. 61 (1), pp. 162572. Date of Electronic Publication: 2025 Aug 18. |
| Publication Type: | Journal Article; Comparative Study |
| Language: | English |
| Journal Info: | Publisher: Saunders Country of Publication: United States NLM ID: 0052631 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1531-5037 (Electronic) Linking ISSN: 00223468 NLM ISO Abbreviation: J Pediatr Surg Subsets: MEDLINE |
| Imprint Name(s): | Publication: Philadelphia, PA : Saunders; Original Publication: New York. |
| MeSH Terms: | Hernias, Diaphragmatic, Congenital*/surgery ; Herniorrhaphy*/methods ; Surgical Flaps*; Postoperative Complications/epidemiology ; Postoperative Complications/etiology ; Humans ; Retrospective Studies ; Female ; Male ; Recurrence ; Treatment Outcome ; Follow-Up Studies ; Infant, Newborn ; Infant |
| Abstract: | Purpose: Infants with large congenital diaphragmatic hernia (CDH) defects pose a clinical challenge. Despite evidence that muscle flap repair (MFR) has lower recurrence rates than patch repair (PR), MFR remains uncommon and understudied. This study evaluated long-term outcomes in CDH patients who underwent MFR compared to PR at a single institution. We hypothesized that patients who underwent MFR have lower recurrence rates than patients who underwent PR.; Methods: Using an internal institutional registry, we identified all CDH patients who underwent repair between 1998 and 2024. Patients were stratified based on repair type, excluding primarily and non-repaired patients. Long-term follow-up was obtained through our institutional pulmonary hypoplasia clinic and retrospective chart review, with supplementary phone calls made to patients who were lost to follow-up. Our primary outcome was CDH recurrence and secondarily wound infection, small bowel obstruction (SBO), abdominal wall hernia, scoliosis and pectus excavatum. Analysis was done using bivariate comparisons.; Results: A retrospective cohort of 456 patients with CDH from 1998 to 2024 was identified. 71 patients were not repaired, and 246 underwent primary repair. The remaining 139 patients underwent complex repair: 108 MFR and 31 PR. 32 did not survive after repair to discharge from NICU (19 MFR and 13 PR). 12 patients were lost to follow-up and we have reliable long-term follow-up in 95 patients. Of these, there are 80 MFR and 15 PR. The median follow-up time was 5 years [IQR 3-11]. Demographics were similar across cohorts. In the MFR group, 5/80 (6.3 %) had a recurrence compared to 7/15 (46.7 %) in the patch group (p= |
| Contributed Indexing: | Keywords: Congenital diaphragmatic hernia; Muscle flap repair; Pediatric surgery |
| Entry Date(s): | Date Created: 20250820 Date Completed: 20260111 Latest Revision: 20260113 |
| Update Code: | 20260130 |
| DOI: | 10.1016/j.jpedsurg.2025.162572 |
| PMID: | 40834916 |
| Database: | MEDLINE |
Journal Article; Comparative Study