Recurrence following congenital diaphragmatic hernia repair: a twelve-year single-center review
In brief
Congenital diaphragmatic hernia repair recurred in 7% of patients overall
In this 489-patient review, recurrence occurred in 7% overall: 3.5% after primary repair, 11.2% after patch repair and 5.4% after muscle flap repair. The patch and muscle flap rates did not differ significantly, but muscle flap patients had shorter follow-up, limiting comparison; longer observation is needed to clarify whether recurrence risks truly differ.
- Journal
- Journal of pediatric surgery (Q1)
- Published
- 26 October 2026
- Study design
- Retrospective cohort
- Evidence level
- Level 3, Low (CEBM 3b)
- Authors
- Felix R De Bie, Sierra Land, Sabrina Flohr, Leny Mathew, Thomas Reynolds, Alan W Flake, et al.
- PMID
- 42933563
- DOI
- 10.1016/j.jpedsurg.2026.163561
Why clinicians should know about it
- Picked for Pediatric Surgery (paper of the day, 28 October 2026): Congenital diaphragmatic hernia repair recurrence and technique outcomes
Abstract
PURPOSE: Recurrence following congenital diaphragmatic hernia (CDH) repair remains an important source of morbidity. In 2021, our institution transitioned from patch to muscle flap repair for larger defects. We aimed to evaluate recurrence rates by repair type over an extended follow-up period. METHOD: ology: We performed a single-center retrospective cohort study of patients with CDH born between January 2013 and March 2025 who underwent repair at our institution. Demographic, operative, and follow-up data were abstracted from the electronic health record. Repair type was classified as primary, patch, or muscle flap. The primary outcome was recurrence. Multivariable logistic regression adjusted for age at repair, defect size, observed-to-expected lung-to-head ratio, and extracorporeal membrane oxygenation use. RESULTS: Of 554 patients born with CDH during the study period, 489 underwent surgical repair: 200 primary, 197 patch, and 92 muscle flap repairs. Overall recurrence occurred in 34 patients (7.0%): 3.5% after primary repair, 11.2% after patch repair, and 5.4% after muscle flap repair. Compared with the patch cohort, the muscle flap group had shorter follow-up (2.50 ± 1.47 vs 5.46 ± 2.87 years, p<0.001) and more D-type defects (19.6% vs 7.6%, p=0.005). Difference in recurrence between patch and muscle flap repair did not reach statistical significance (p=0.134). Multivariable analysis identified no independent predictor of recurrence. CONCLUSION: Recurrence after CDH repair was uncommon overall and lowest after primary repair. Muscle flap and patch repairs had similar recurrence rates, though muscle flap recurrences were more often amenable to primary re-repair. Longer follow-up may allow for more definitive comparisons.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.