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Surgical complications, especially gastroesophageal reflux disease, intestinal adhesion obstruction, and diaphragmatic hernia recurrence, are major sequelae in survivors of congenital diaphragmatic hernia.
[congenital diaphragmatic hernia]
This
study
aimed
to
characterize
the
surgical
complications
,
especially
gastroesophageal
reflux
disease
(
GERD
)
,
intestinal
adhesion
obstruction
(
IAO
)
,
and
diaphragmatic
hernia
recurrence
,
in
patients
with
congenital
diaphragmatic
hernia
(
CDH
)
.
Between
January
1995
and
December
2013
,
we
determined
the
incidence
of
surgical
complications
and
their
predictors
in
CDH
patients
.
We
also
examined
whether
the
CDH
repair
and
patch
closure
were
associated
with
the
incidence
of
IAO
and
the
severity
of
adhesion
.
Seventy
-
four
CDH
survivors
were
evaluated
.
GERD
occurred
in
28
patients
(
37
.
8
%
)
and
recurred
in
8
patients
(
10
.
8
%
)
.
Stomach
herniation
was
a
risk
factor
for
GERD
,
and
occurred
in
25
patients
.
IAO
occurred
in
13
patients
(
17
.
6
%
)
.
In
240
neonatal
laparotomies
in
the
same
period
,
the
incidence
of
IAO
was
significantly
higher
in
patients
who
underwent
CDH
repair
than
in
patients
who
underwent
other
neonatal
laparotomy
(
p
=
0
.
023
)
.
Surgical
time
and
intraoperative
bleeding
were
significantly
greater
following
CDH
repair
with
an
artificial
patch
compared
with
CDH
repair
with
direct
closure
.
Surgical
complications
are
major
sequelae
in
survivors
of
CDH
repair
.
CDH
repair
and
artificial
patch
closure
were
significantly
associated
with
the
incidence
of
IAO
and
the
severity
of
adhesion
.