Purpose:
Recurrence of congenital diaphragmatic hernia (CDH) was retrospectively evaluated after
correction with or without a patch in an institution where tension-free repair is advocated. //
Methods:
Demographics and outcomes of patients with a postero-lateral CDH repaired (2000-2016) were
analysed (univariate tests and binary logistic regression adjusting for time since start of study,
gender, defect side, liver herniation, patch, surgical approach, absence of postero-lateral rim
and length of follow-up). //
Results:
Of 203 patients, 107 received a patch (P), and 96 were not patched (NP). Groups were not
different for gestational age birthweight, gender, defect side and minimally-invasive approach
rate. Preoperative ECMO incidence (P:29.9% vs. NP:2.1%, p<0.01), liver herniation (P:57.0%
vs. NP:22.9%, p<0.01) and absence of a postero-lateral rim (P:61.7% vs. NP:8.3%, p<0.01)
were higher in the P group. The mortality rate was 10.8% (P:15.0% vs. NP:6.2%, p=0.07).
Recurrence was not different (P:9.3% vs. NP:4.2%, p=0.15). Multivariate analysis showed that
recurrence was higher after thoracoscopy compared to open (OR=12.2 [2.2-68], p<0.01);
neither the use of patch (OR=2.3, [0.5-10.4], p=0.28) nor any other factors were associated with
recurrence. //
Conclusion:
In this single centre series where tension-free repair was advocated, patch repair of CDH was
not associated with higher recurrence, though access route was
