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Early Removal of the Abdominal Patch is Superior to Late Removal in Children With Congenital Diaphragmatic Hernia.

J Pediatr Surg

December 2024

Department of Pediatric Surgery, University Medical Center Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, Mannheim 68167, Germany. Electronic address:

Introduction: Open repair of Congenital diaphragmatic hernia (CDH) in neonates often involves reconstruction of the abdominal wall using a patch. Data on predictors for the need of a patch and associated postoperative risks, such as infection or patch detachment, are limited. Specifically, the question regarding the ideal timepoint of patch removal remains unanswered.

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Introduction: The rarest form of renal ectopia, the thoracic kidney, has been documented in only about 200 cases worldwide. There are four recognized causes of congenital thoracic renal ectopia: renal ectopia with an intact diaphragm, diaphragmatic eventration, diaphragmatic hernia, and traumatic diaphragmatic rupture. This condition often presents as an incidental finding in asymptomatic patients.

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Background/aim: Congenital diaphragmatic hernia (CDH) is a critical condition affecting newborns, which often results in long-term morbidities, including neurodevelopmental delays, which affect cognitive, motor, and behavioral functions. These delays are believed to stem from prenatal and postnatal factors, such as impaired lung development and chronic hypoxia, which disrupt normal brain growth. Understanding the underlying mechanisms of these neurodevelopmental impairments is crucial for improving prognosis and patient outcomes, particularly as advances in treatments like ECMO have increased survival rates but also pose additional risks for neurodevelopment.

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