Congenital diaphragmatic hernia in adults: a decade of experience from a single tertiary center

Figures & data

Figure 1. A sagittal view of a left-sided Bochdalek hernia from a CT scan. Omental fat as well as the left kidney can be seen herniating through the posterolateral hernia defect in the diaphragm.

Figure 2. A sagittal view of a Morgagni hernia from a CT scan showing the defect in the anteromedial part of the diaphragm and the bowel herniated into the thoracic cavity.

Table 1. Patient demographics.

	All patients n (%)	MI (n = 29) n (%)	Open (n = 8) n (%)	p
Sex
Female	25 (67.6)	20 (69.0)	5 (62.5)	1.00
Male	12 (32.4)	9 (31.0)	3 (37.5)
Age
Median (range)	57.1 (20–80)	57.1 (20–80)	57.3 (31–80)	.982
BMI (n = 32)
Median (range)	28.6 (17–59)	30.3 (21–59)	23.2 (17–30)	.003
CCI
Median (range)	1.81 (0–5)	1.76 (0–5)	2.0 (0–5)	.719
Smoking
Yes	6 (16.2)	6 (20.7)	0 (0)	.328
Never	18 (48.6)	13 (44.8)	5 (62.5)
Former smoker	13 (35.1)	10 (34.5)	3 (37.5)
Presenting symptoms
Gastrointestinal	19 (51.4)	13 (44.8)	6 (75.0)	.232
Respiratory	11(29.7)	9 (31.0)	2 (25.0)	1.000
Asymptomatic	7 (18.9)	7 (24.1)	0 (0)	.308
Type of hernia
Morgagni	30 (81.1)	26 (89.7)	4 (50)	.027
Bochdalek	7 (18.9)	3 (10.3)	4 (50)

MI: minimally invasive; BMI: body mass index; CCI: Charlson Comorbidity Index.

Table 2. Hernia and operative characteristics in minimally invasive and open repairs.

	All patients (n = 37) n (%)	MI (n = 29) n (%)	Open (n = 8) n (%)	Morgagni (n = 30) n (%)	Bochdalek (n = 7) n (%)
Emergency
Defect size (cm)	13 (35.1)	8 (27.6)	5 (62.5)	8 (26.7)	5 (71.4)
Median (range)	6.2 (3–10)	6.4 (3–10)	5.4 (3–10)	6.1 (3–10)	6.7 (3–10)
Side
Right	27 (73.0)	20 (69.0)	7 (87.5)	23 (76.7)	4 (57.1)
Left	6 (16.2)	5 (17.2)	1 (12.5)	3 (10.0)	3 (42.9)
Bilateral	4 (10.8)	4 (13.8)	0 (0)	4 (13.3)	0 (0)
Hernia contents
Omental fat only	9 (24.3)	9 (31.0)	0 (0)	9 (30.0)	0 (0)
Bowel, other organs	28 (75.7)	20 (69.0)	100 (0)	21 (70.0)	7 (100)
Sac excision	35 (94.6)	28 (96.6)	7 (87.5)	29 (96.7)	6 (85.7)
Mesh	19 (51.4)	15 (51.7)	4 (50.0)	15 (50)	4 (57.1)
Operative time (min)
Median (range)	118 (38–240)	121 (38–240)	109 (50-235)	113 (38–240)	138 (42–235)
Length of stay (days)
Median (range)	4.3 (1–13)	3.6 (1–13)	6.8 (4–11)	3.7 (1–13)	6.7 (2–11)
Follow-up (months)
Median (range)	48.2 (1–116)	45.6 (1–116)	57.4 (7–114)	52.7 (3–116)	28.71 (1–66)

MI: minimally invasive.

Table 3. Adverse events.

	All patients n (%)	MI n (%)	Open n (%)	p
Complications
Grade II	2 (5.4)	1 (3.4)	1 (12.5)
Grade III	4 (10.8)	3 (10.3)	1 (12.5)
Grade IV	1 (2.7)	1 (3.4)	0 (0)
Total	7 (18.9)	5 (17.2)	2 (25.0)	.631
90-day mortality	0 (0)	0 (0)	0 (0)	1.000
Readmission	2 (5.4)	1 (3.4)	1 (12.5)	.390
Reoperation	4 (10.8)	2 (6.9)	2 (25.0)	.198
Recurrence	0 (0)	0 (0)	0 (0)	1.000

MI: minimally invasive.

Table 4. Logistic regression analysis of factors affecting complication rate.

	OR	95% CI	p
Age	1.01	0.81–1.27	.917
Female gender	0.59	0.08–4.22	.590
Emergency operation	0.55	0.01–10.42	.704
Minimally invasive surgery	0.42	0.05–3.99	.419
Mesh augmentation	0.49	0.06–3.23	.465
CCI	0.51	0.04–5.09	.566

CCI: Charlson Comorbidity Index; CI: confidence interval.

Data availability statement

The data are available from the author. Code availability (software application or custom code).