Surgical treatment of diaphragmatic agenesis by transposition of a muscle flap: Report on 15 cases

Between 1987 and 1996 the transposition of a muscle flap using the anterola teral abdominal wall (the internal oblique and transversus abdominus muscle ) has been used for the surgical treatment of fifteen cases of diaphragmati c agenesis. There are several advantages of this technique: a more accurate reconstruct ion of the diaphragmatic dome, a better adapted muscle flap, good tolerance and evolution as a result of the use of autologous material with thus less risk of recurrence and/or infection. The disadvantages are represented by the nine cases of abdominal herniation at the site of the muscle flap, three of which necessitated secondary surg ical treatment. Nine children survived this treatment, six died following severe cardio-pul monary complications associated with this malformation.