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Small Bowel Obstruction Following Congenital Diaphragmatic Hernia Repair-Incidence and Risk Factors.
Schmoke, Nicholas; Cali, Francesca; Wilken, Terri; Midura, Devin; Nemeh, Christopher; Fan, Weijia; Khlevner, Julie; Duron, Vincent.
Afiliación
  • Schmoke N; Division of Pediatric Surgery, Department of Surgery, Columbia University Vagelos College of Physicians and Surgeons, NewYork-Presbyterian Morgan Stanley Children's Hospital, New York, NY, USA.
  • Cali F; Division of Pediatric Surgery, Department of Surgery, Columbia University Vagelos College of Physicians and Surgeons, NewYork-Presbyterian Morgan Stanley Children's Hospital, New York, NY, USA.
  • Wilken T; Division of Pediatric Surgery, Department of Surgery, Columbia University Vagelos College of Physicians and Surgeons, NewYork-Presbyterian Morgan Stanley Children's Hospital, New York, NY, USA.
  • Midura D; Division of Pediatric Surgery, Department of Surgery, Columbia University Vagelos College of Physicians and Surgeons, NewYork-Presbyterian Morgan Stanley Children's Hospital, New York, NY, USA.
  • Nemeh C; Division of Pediatric Surgery, Department of Surgery, Columbia University Vagelos College of Physicians and Surgeons, NewYork-Presbyterian Morgan Stanley Children's Hospital, New York, NY, USA.
  • Fan W; Department of Biostatistics, Columbia University Mailman School of Public Health, New York, NY, USA.
  • Khlevner J; Division of Pediatric Gastroenterology, Hepatology, and Nutrition. Columbia University Vagelos College of Physicians and Surgeons, NewYork-Presbyterian Morgan Stanley Children's Hospital, New York, NY, USA.
  • Duron V; Division of Pediatric Surgery, Department of Surgery, Columbia University Vagelos College of Physicians and Surgeons, NewYork-Presbyterian Morgan Stanley Children's Hospital, New York, NY, USA.
Am Surg ; 90(12): 3223-3228, 2024 Dec.
Article en En | MEDLINE | ID: mdl-39030940
ABSTRACT

BACKGROUND:

Small bowel obstruction (SBO) is a known complication following congenital diaphragmatic hernia (CDH) repair, resulting in significant morbidity and potential mortality. Our study aims to evaluate the incidence and risk factors for SBO following CDH repair.

METHODS:

A single-institution retrospective review evaluated all CDH births between January 2010 and September 2022 (n = 120). Risk factors for SBO were analyzed, including operative approach, type of repair, need for extracorporeal membrane oxygenation (ECMO), and additional abdominal surgeries (gastrostomy tube and fundoplication).

RESULTS:

120 patients were included. 16 (13%) patients developed an SBO, of which 94% were due to adhesive bands. The median time to SBO was 7.5 months. 15/16 (94%) patients required operative intervention. Need for ECMO (P < 0.01), prior gastrostomy tube (P < 0.01), and prior fundoplication (P < 0.01) were associated with an increased risk of SBO, as were longer time to initial CDH repair (6 days vs 3 days; P < 0.01) and longer length of initial hospitalization (63 days vs 29 days; P = 0.01).

DISCUSSION:

Neonates with increased acuity of illness (ie, those requiring ECMO, additional abdominal operations, longer time to repair, and longer initial hospitalizations) appear to have an increased risk of developing adhesive SBO after CDH repair. More than 90% of patients who developed SBO required surgery.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Complicaciones Posoperatorias / Herniorrafia / Hernias Diafragmáticas Congénitas / Obstrucción Intestinal / Intestino Delgado Límite: Female / Humans / Male / Newborn Idioma: En Revista: Am Surg Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Complicaciones Posoperatorias / Herniorrafia / Hernias Diafragmáticas Congénitas / Obstrucción Intestinal / Intestino Delgado Límite: Female / Humans / Male / Newborn Idioma: En Revista: Am Surg Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos