Macchini Francesco, Raffaeli Genny, Amodeo Ilaria, Ichino Martina, Encinas José Luis, Martinez Leopoldo, Wessel Lucas, Cavallaro Giacomo
Department of Pediatric Surgery, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
Neonatal Intensive Care Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
Front Pediatr. 2022 Feb 9;10:823180. doi: 10.3389/fped.2022.823180. eCollection 2022.
Recurrence is one of the most common surgical complications in Congenital Diaphragmatic Hernia (CDH). It could remain clinically silent for a long time or present as an acute complication week, months, or even years after the primary surgery. Several risk factors have been identified so far. An extended diaphragmatic defect represents one of the leading independent risk factors, together with indirect signs of large defect such as the liver position related to the diaphragm and the use of the prosthetic patch and with the use of a minimally invasive surgical (MIS) approach. However, the exact contribution of each factor and the overall risk of recurrence during the life span still need to be fully understood. This mini-review aims to give an overview of the current knowledge regarding CDH recurrence, focusing on predisposing factors, clinical presentation, management and follow-up of high-risk patients, and future perspectives.
复发是先天性膈疝（CDH）最常见的手术并发症之一。它可能在临床上长期无症状，或在初次手术后数周、数月甚至数年表现为急性并发症。目前已确定了几个危险因素。扩大的膈肌缺损是主要的独立危险因素之一，此外还有大缺损的间接征象，如肝脏与膈肌的位置关系、人工补片的使用以及微创外科（MIS）手术方法的使用。然而，每个因素的确切作用以及一生中复发的总体风险仍有待充分了解。本综述旨在概述目前关于CDH复发的知识，重点关注高危患者的易感因素、临床表现、管理和随访以及未来展望。
