Evidence map›Paper›PMID 41729300›Full record

SynthesisPediatric surgery international2026

Muscle flap repair vs. patch repair in reducing recurrence in congenital diaphragmatic hernia: systematic review with Meta-Analysis.

Anastasia M Kahan, Robert A Swendiman, Michael D Traynor, Bradley Yoder, Michelle Yang, Kelsea Peterson, Stephen J Fenton, Zachary J Kastenberg, Sajesh K Veettil, Nathorn Chaiyakunapruk and 1 more

Abstract readSystematic ReviewMeta-AnalysisComparative Study
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In one paragraph

Synthesis in Pediatric surgery international, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Anastasia M KahanDepartment of Surgery, Division of Pediatric Surgery, University of Utah, Salt Lake City, UT, USA. Sasha.kahan@hsc.utah.edu.
Robert A SwendimanDepartment of Surgery, Division of Pediatric Surgery, University of Utah, Salt Lake City, UT, USA.
Michael D TraynorDepartment of Surgery, Division of Pediatric Surgery, University of Utah, Salt Lake City, UT, USA.
Bradley YoderDepartment of Pediatrics, Division of Neonatology, University of Utah, Salt Lake City, UT, USA.
Michelle YangDepartment of Pediatrics, Division of Neonatology, University of Utah, Salt Lake City, UT, USA.
Kelsea PetersonDepartment of Surgery, Division of Pediatric Surgery, University of Utah, Salt Lake City, UT, USA.
Stephen J FentonDepartment of Surgery, Division of Pediatric Surgery, University of Utah, Salt Lake City, UT, USA.
Zachary J KastenbergDepartment of Surgery, Division of Pediatric Surgery, University of Utah, Salt Lake City, UT, USA.
Sajesh K VeettilDepartment of Pharmacotherapy, University of Utah, Salt Lake City, UT, USA.
Nathorn ChaiyakunaprukDepartment of Pharmacotherapy, University of Utah, Salt Lake City, UT, USA.
Katie W RussellDepartment of Surgery, Division of Pediatric Surgery, University of Utah, Salt Lake City, UT, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveThis meta-analysis aimed to investigate the risk of recurrence after muscle flap repair versus patch repair in neonates with congenital diaphragmatic hernia (CDH).

methodsThree electronic databases (PubMed, EMBASE, and CENTRAL) were searched from inception until November 1, 2024, to identify studies that compared patch repair and muscle flap repair and reported recurrence rates or any other relevant secondary outcomes in neonates with CDH. Two reviewers independently extracted data and evaluated study quality using ROBINS-I. The primary outcome was the risk of recurrence presented as a risk ratio (RR) with 95% CI. Secondary outcomes included adhesive small bowel obstruction, scoliosis, and survival to discharge. Meta-analytic estimates were calculated with a random-effects model.

resultsSix retrospective cohort studies involving a total of 300 patients were included for meta-analysis. Meta-analysis suggested that muscle flap repair significantly reduced the risk for recurrence after repair of CDH compared to patch repair (RR, 0.30 (95% CI, 0.15 to 0.63), I2 = 0%). The finding remained robust after a sensitivity analysis excluding critically biased studies. Meta-analyses did not find any significant differences between muscle flap and patch repair for the secondary outcomes of small bowel obstruction (RR, 1.77 (95% CI, 0.56 to 5.56), I2 = 0%), scoliosis (RR, 1.54 (95% CI, 0.57 to 4.13), I2 = 0%), and survival to discharge (RR, 1.07 (95% CI 0.84 to 1.38), I2 = 0%).

conclusionsOur findings demonstrate that neonates with CDH undergoing muscle flap repair have a 70% decreased risk of recurrence compared to patch repair. Secondary analyses did not show statistically significant differences between the two groups.

Indexed as

Hernias, Diaphragmatic, CongenitalHerniorrhaphySurgical FlapsHumansInfant, NewbornRecurrenceCongenital diaphragmatic herniaMeta-analysisMuscle flap repairPediatric surgery

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.