title: Newly designed bioabsorbable substitute for the treatment of diaphragmatic defects.
abstract: OBJECTIVE
  Earlier studies have investigated the suitability of various materials and autologous grafts for the repair of diaphragmatic defects. Our group investigated the feasibility of using an artificial diaphragm (AD) to repair wide diaphragmatic defects.
  
  
  METHODS
  Twelve pigs were laparotomized and, in each pig, a defect was fashioned by resecting a round 8-cm diameter hole in the left diaphragm. Next, the defect was repaired by implanting an AD. The animals were relaparotomized 8 or 24 weeks after implantation for gross, histological and radiological observation of the implanted sites.
  
  
  RESULTS
  All recipient animals survived until killing for evaluation. Chest X-ray examinations showed no differences between the preoperative diaphragms and the grafted diaphragms at 8 and 24 weeks after implantation. At 8 weeks after implantation, the implanted sites exhibited fibrous adhesions to the liver and lungs without deformities or penetrations. Parts of the surface tissue at the graft sites had a varnished appearance similar to those of the native diaphragm. Histology performed at 8 weeks detected no trace of the ADs in the graft sites; however, numerous inflammatory cells and profuse fibrous connective tissue were observed. At 24 weeks after implantation, no differences were found in the thorax between the areas with the grafts and the unaffected areas. Histology of the graft sites in the thorax confirmed growth of mesothelial cells similar to that observed in the native diaphragm.
  
  
  CONCLUSIONS
  Artificial diaphragms can be a novel substitute for diaphragmatic repair.
authors.affiliation: Department of Surgery, Gastrointestinal Center, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka, Saitama, 350-1298, Japan.
authors.forename: Masayasu
authors.initials: M
authors.lastname: Aikawa
authors.forename: Mitsuo
authors.initials: M
authors.lastname: Miyazawa
authors.forename: Kojun
authors.initials: K
authors.lastname: Okamoto
authors.forename: Yasuko
authors.initials: Y
authors.lastname: Toshimitsu
authors.forename: Katsuya
authors.initials: K
authors.lastname: Okada
authors.forename: Naoe
authors.initials: N
authors.lastname: Akimoto
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Ueno
authors.forename: Isamu
authors.initials: I
authors.lastname: Koyama
authors.forename: Yoshito
authors.initials: Y
authors.lastname: Ikada
mesh_terms: D020341:Absorbable Implants; D000818:Animals; D002208:Caproates; D003964:Diaphragm / Q000601:surgery*; D004195:Disease Models, Animal; D006548:Hernia, Diaphragmatic / Q000601:surgery; D065630:Hernias, Diaphragmatic, Congenital; D006820:Hyaluronic Acid; D019344:Lactic Acid; D007783:Lactones; D008567:Membranes, Artificial; D011100:Polyglycolic Acid; D011108:Polymers; D011474:Prosthesis Design; D019651:Plastic Surgery Procedures / Q000379:methods*; D013552:Swine
chemical_list: D002208:Caproates; D007783:Lactones; D008567:Membranes, Artificial; D011108:Polymers; D011100:Polyglycolic Acid; D019344:Lactic Acid; C121056:caprolactone; D006820:Hyaluronic Acid