Recurrent congenital diaphragmatic hernia: A novel repair. 
Repair of recurrent diaphragmatic hernia continues to be a difficult problem.  An innovative method using a nonabsorbable polypropylene prosthetic mesh plug placed via the thoracic approach using minimal dissection is presented.  A retrospective analysis showed 39 children with congenital diaphragmatic hernia (CDH) who underwent repair between January 1997 and March 2000.  Five children suffered a recurrence and underwent repair via the thoracic approach using the Bard Marlex Mesh Perfix Plug (C.R. Bard Inc, Billerica, MA).  Follow-up was available in all children and ranged from 1 to 33 months (average, 13.8 months).  Age at recurrence ranged from 2 to 48 months (average, 14.8 months), and the average time between initial repair and recurrence was 8.2 months (range, 2 to 16 months).  There were no recurrences after the transthoracic mesh plug diaphragmatic hernioplasty.  One child died of multiple congenital anomalies 6 months after repair.  The transthoracic repair of recurrent diaphragmatic hernias using a nonabsorbable polypropylene prosthetic mesh plug represents an innovative approach to a difficult problem in which 5 repairs have been accomplished without recurrence in nearly 14 months of follow-up.  J Pediatr Surg 36:1768-1769.