Biological versus synthetic patch for the repair of congenital diaphragmatic hernia: 8-year experience at a tertiary center
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Read the article on pubmed.ncbi.nlm.nih.gov ↗Article · Jan 2022 · 1 min read
In brief
In brief
Retrospective study of 195 CDH patients over 8 years demonstrates PTFE patches have significantly lower recurrence rates (4%) compared to biological SIS patches (50%) for large diaphragmatic defects, with no difference in mortality or length of stay. Findings support institutional transition to synthetic PTFE for CDH repair.
Written by the GCMD Library team from the article.
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.
DOI: 10.1016/j.jpedsurg.2021.02.052