Prosthetic patches for congenital diaphragmatic hernia repair: Surgisis vs Gore-Tex

The sequelae of congenital diaphragmatic hernia (CDH) continue well beyond the perinatal period. Up to 50% of these patients have subsequent recurrent herniation or small bowel obstruction (SBO). A recent trend has been toward the use of bioactive prosthetic materials. We reviewed different patch cl...

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Published inJournal of pediatric surgery Vol. 41; no. 1; pp. 29 - 33
Main Authors Grethel, Erich J., Cortes, Raul A., Wagner, Amy J., Clifton, Matthew S., Lee, Hanmin, Farmer, Diana L., Harrison, Michael R., Keller, Roberta L., Nobuhara, Kerilyn K.
Format Journal Article
LanguageEnglish
Published United States Elsevier Inc 2006
Subjects
Biocompatible Materials
Hernia, Diaphragmatic - surgery
Hernias, Diaphragmatic, Congenital
Humans
Infant, Newborn
Polytetrafluoroethylene
Prosthesis Design
Recurrence
Retrospective Studies
Surgical Mesh
Treatment Outcome
Prosthetic patch
Gore-Tex
Congenital diaphragmatic hernia
Surgisis
Hernia recurrence
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Summary:The sequelae of congenital diaphragmatic hernia (CDH) continue well beyond the perinatal period. Up to 50% of these patients have subsequent recurrent herniation or small bowel obstruction (SBO). A recent trend has been toward the use of bioactive prosthetic materials. We reviewed different patch closure techniques used for CDH repair at our institution and their association with these sequelae. A retrospective review was performed of 152 records for patients with CDH. Newborns that underwent patch repair for CDH and survived for at least 30 days were included in the analysis. Primary outcomes evaluated were recurrent herniation and SBO. Two types of prostheses were examined, Gore-Tex, an artificial material, and Surgisis, a bioactive material. Twelve (44%) of 27 patients who had Surgisis repair had recurrent herniation. Seventeen (38%) of 45 patients who had a Gore-Tex repair had recurrent herniation. Two additional patients in each group presented with SBO. No significant difference in recurrent herniation rates was observed ( P > .5). The time to recurrence was similar in both groups (log-rank, P = .75), with most recurrences (92% Surgisis, 76% Gore-Tex) occurring in the first year. The rates of recurrent herniation and SBO after neonatal prosthetic patch repair of CDH were similar regardless of the prosthetic material used (Surgisis or Gore-Tex).
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ISSN:0022-3468
1531-5037
DOI:10.1016/j.jpedsurg.2005.10.005