%0 Journal Article
%T Abdominal wall muscle weakness outcomes after split abdominal flap repair of large congenital diaphragmatic hernias in newborn.
%A Molino JA
%A Guillen G
%A Khan HA
%A López Fernández S
%A Martos Rodríguez M
%A Rocha O
%A López Paredes M
%J Pediatr Surg Int
%V 40
%N 1
%D 2024 Jul 3
%M 38958763
%F 2.003
%R 10.1007/s00383-024-05751-8
%X <B>OBJECTIVE: </B>Split abdominal wall muscle flap (SAWMF) is a technique to repair large defects in congenital diaphragmatic hernia (CDH). A possible objection to this intervention could be any associated abdominal muscle weakness. Our aim is to analyze the evolution of this abdominal muscle wall weakness.<BR><B>METHODS: </B>Retrospective review of CDH repair by SAWMF (internal oblique muscle and transverse) from 2004 to 2023 focusing on the evolution of muscle wall weakness.<BR><B>RESULTS: </B>Eighteen neonates of 148 CDH patients (12,1%) were repaired using SAWMF. Mean gestational age and birth weight were 35.7 ± 3.5 weeks and 2587 ± 816 g. Mean lung-to-head ratio was 1.49 ± 0.28 and 78% liver-up. Seven patients (38%) were prenatally treated by tracheal occlusion. Ninety-four percent of the flaps were used for primary repair and one to repair a recurrence. One patient (5.6%) experienced recurrence. Abdominal muscle wall weakness was present in the form of a bulge. Resolution of weakness at 1, 2 and 3 years was 67%, 89% and 94%, respectively. No patient required treatment for weakness or died.<BR><B>CONCLUSIONS: </B>Abdominal muscular weakness after a split abdominal wall muscle flap repair is not a limitation for its realization since it is asymptomatic and presents a prompt spontaneous resolution.<BR><B>METHODS: </B>IV.