Surgical Management and Outcomes of Congenital Diaphragmatic Hernia in Neonates: A Systematic Review

Authors

  • Samina Ruquaya
  • Praveena Gaddam
  • Athira Gopinathan

Keywords:

Congenital diaphragmatic hernia, CDH, neonates, surgical intervention, thoracoscopic repair, ECMO, outcomes, fetal surgery, long-term morbidity, multidisciplinary care

Abstract

Congenital diaphragmatic hernia (CDH) is a severe neonatal disorder characterized by inadequate diaphragm development, leading to pulmonary hypoplasia and hypertension. Notwithstanding advancements in neonatal treatment, congenital diaphragmatic hernia (CDH) is linked to considerable morbidity and mortality. This systematic review assesses contemporary surgical techniques—spanning open and thoracoscopic repair to ECMO-assisted procedures—and their results in newborns with congenital diaphragmatic hernia (CDH). A comprehensive literature review was performed across various databases for studies published from 2000 to 2025. The research indicates that postponing surgical repair following preoperative stabilization results in superior outcomes compared to immediate surgery. Although minimally invasive surgery demonstrates potential for certain stable neonates, open repair continues to be the standard for critically ill patients. Patch repair is frequently essential for substantial flaws but entails increased chances of recurrence. The utilization of ECMO, while life-saving in critical instances, entails long-term neurodevelopmental hazards. Postoperative problems, including pulmonary hypertension, recurrence, and long-term morbidities such as chronic lung disease and developmental disabilities, persist. The prognosis is affected by elements including prenatal severity indicators, liver herniation, genetic abnormalities, and available institutional resources. The review highlights future directions, such as advancements in fetal surgery like FETO, the creation of novel surgical procedures, and the establishment of multidisciplinary follow-up programs to improve the quality of life for survivors. A customized, evidence-driven strategy is crucial for enhancing outcomes in infants with congenital diaphragmatic hernia (CDH).

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References

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Published

2025-04-25

How to Cite

1.
Ruquaya S, Gaddam P, Gopinathan A. Surgical Management and Outcomes of Congenital Diaphragmatic Hernia in Neonates: A Systematic Review. J Neonatal Surg [Internet]. 2025Apr.25 [cited 2025Sep.19];14(6):632-40. Available from: https://www.jneonatalsurg.com/index.php/jns/article/view/4625

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Vol. 14 No. 6 (2025): Journal of Neonatal Surgery

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Original Article

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