title: Surgical complications, especially gastroesophageal reflux disease, intestinal adhesion obstruction, and diaphragmatic hernia recurrence, are major sequelae in survivors of congenital diaphragmatic hernia.
abstract: OBJECTIVE
  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).
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Pediatric Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai, Showa, Nagoya, 466-8550, Japan.
authors.forename: Kazuki
authors.initials: K
authors.lastname: Yokota
authors.forename: Hiroo
authors.initials: H
authors.lastname: Uchida
authors.forename: Kenichiro
authors.initials: K
authors.lastname: Kaneko
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Ono
authors.forename: Naruhiko
authors.initials: N
authors.lastname: Murase
authors.forename: Satoshi
authors.initials: S
authors.lastname: Makita
authors.forename: Masahiro
authors.initials: M
authors.lastname: Hayakawa
mesh_terms: D015897:Comorbidity; D005260:Female; D005764:Gastroesophageal Reflux / Q000453:epidemiology*; D065630:Hernias, Diaphragmatic, Congenital / Q000453:epidemiology* / Q000601:surgery*; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D007415:Intestinal Obstruction / Q000453:epidemiology*; D007564:Japan / Q000453:epidemiology; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology*; D012008:Recurrence; D012307:Risk Factors; D017741:Survivors / Q000706:statistics & numerical data; D000267:Tissue Adhesions / Q000453:epidemiology*
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