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


METHODS
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.


RESULTS
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.


CONCLUSIONS
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).
Grethel
Erich J
EJ
Division of Pediatric Surgery, University of California, San Francisco, San Francisco, CA 94143, USA. grethele@surgery.ucsf.edu
Cortes
Raul A
RA
Wagner
Amy J
AJ
Clifton
Matthew S
MS
Lee
Hanmin
H
Farmer
Diana L
DL
Harrison
Michael R
MR
Keller
Roberta L
RL
Nobuhara
Kerilyn K
KK
D001672:Biocompatible Materials; D006548:Hernia, Diaphragmatic / Q000601:surgery*; D065630:Hernias, Diaphragmatic, Congenital; D006801:Humans; D007231:Infant, Newborn; D011138:Polytetrafluoroethylene; D011474:Prosthesis Design; D012008:Recurrence; D012189:Retrospective Studies; D013526:Surgical Mesh; D016896:Treatment Outcome
D001672:Biocompatible Materials; D011138:Polytetrafluoroethylene