Biological versus synthetic patch for the repair of congenital diaphragmatic hernia: 8-year experience at a tertiary center
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In brief
In brief
Eight-year retrospective study comparing biological (SIS) versus synthetic (PTFE) patches for large congenital diaphragmatic hernia defects shows significantly lower recurrence with PTFE (4% vs 50%, P<0.01). Institution transitioned from SIS to PTFE based on superior outcomes, with no difference in mortality or length of stay between groups.
Written by the GCMD Library team from the article.
Abstract
Purpose
The aim of this study is to compare outcome between small intestinal submucosal (SIS) and polytetrafluoroethylene (PTFE) patches in patients with congenital diaphragmatic hernia (CDH) with large muscular defects.
Material and methods
We performed a retrospective review of prospectively collected data of patients who underwent CDH repair from January 2011 to June 2019, with a minimum follow-up of 1 year. Data were collected regarding length of stay (LOS), mortality and recurrence. Kaplan-Meier analyses was used.
Results
In the study period, 195 patients with CDH were admitted, 176 underwent surgical repair and 19 died before surgery. Sixty-two (35%) required a patch. Over the last 5 years, our institution transitioned from the use of all SIS to all PTFE. SIS was used in 18 cases and PTFE in 25. Overall survival rate was 89% (174/195). There was no significant difference regarding LOS and mortality. Nine patients (50%) of SIS and 1 (4%) of PTFE repairs recurred (P < 0.01; log-rank test P < 0.01), with a time course of recurrence of 18 (SD = 13) and 8 months, respectively. Median follow-up was 60 months (SD: 23) for the SIS group and 26 (SD: 10) for the PTFE group.
Conclusion
A significant lower recurrence was found using PTFE patches instead of SIS for the repair of large CDH.
Level of evidence
Level 3. Retrospective comparative study.