Background: Open repair of congenital diaphragmatic hernia (CDH) in neonates often
requires surgical reconstruction of the abdominal wall. Lateral Release (LR) of the
Abdominal Wall Fascia, a novel technique avoiding prosthetic patches, offers potential
advantages. However, data comparing its outcomes to traditional patch repair are limited.
Methods: A preliminary prospective cohort study was conducted at the University Medical
Center Mannheim from 2021 to 2024, including neonates undergoing CDH surgery with
abdominal wall reconstruction via direct closure, Lateral Release, or patch repair
based on intraoperative surgeon decision. Perioperative, postoperative, and short-term
outcome data were analyzed during our standardized follow-up protocols and compared
between groups.
Results: Among 77 eligible neonates, 11 underwent patch repair and 10 received LR.
Baseline characteristics between groups were comparable. The median follow-up was
391 days in the patch group and 215 days in the LR group (p = 0.1971). The LR group
had significantly shorter median intubation duration, NICU stay, and overall length
of stay (LOS) compared to the patch group (32.0 vs 43.0 days, p = 0.0445; 33.5 vs.
66.0 days, p = 0.0309; 68.0 vs. 97.0 days, p = 0.0435). There were no significant
differences in recurrence rates, short-term complications, or motor developmental
outcomes.
Conclusion: Lateral Release appears to be associated with shorter hospital stays and
faster recovery, without an increase in perioperative or long-term complications.
While these findings suggest potential benefits of LR, they must be interpreted with
caution due to the limited sample size, further randomized, multicenter studies with
larger cohorts, including long-term assessment of complications, are needed to confirm
its efficacy and refine clinical guidelines.
