Outcome of Congenital Diaphragmatic Hernia Repair Depending on Patch Type
Outcome of Congenital Diaphragmatic Hernia Repair Depending on Patch Type
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DOI：
10.1055/s-0030-1261939
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发表时间：
2010-11-01
影响因子：
1.8
通讯作者：
Peter, S. D. St.
中科院分区：
文献类型：
--
作者：
Laituri, C. A.;Garey, C. L.;Peter, S. D. St.
简介：先天性腹股沟疝补片修补术的复发率比一期修补术高得多。修复材料的生物合成选择继续扩大。因此，我们回顾了我们的经验，基准并发症发生率，因为我们的进展与使用新material.Methods：回顾性分析进行了所有患者谁接受了修复先天性疝修补术从1994年1月至2009年5月。结果：155例患者纳入本研究，101例患者有一期关闭和54个收到了疝修补补片。需要补片修补的患者组的复发率、小肠梗阻（SBO）和随后的腹部手术率均显著较高。有3种类型的补片修复：37例患者接受SIS补片，12例接受不可吸收补片，5例接受AlloDerm补片。使用不可吸收补片的患者的SBO发生率为17%，与50%的复发率和67%的再复发率相关。SIS与19%的SBO发生率，22%的复发率和50%的再复发率，而AlloDerm有40%的SBO发生率，40%的复发率，和100%的再复发率。讨论：随着我们走向下一代材料，这些数据并不证明继续比较不可吸收的补丁。我们没有足够的比较数据来定义一种上级生物合成材料，但我们计划使用SIS的数据来衡量我们在下一代材料方面的经验。
Introduction: Patch repair of a congenital diaphragmatic hernia is associated with a much higher rate of recurrence than when primary repair is feasible. The biosynthetic options for the repair materials continue to expand. We therefore reviewed our experience to benchmark complication rates as we progress with the use of new materials.Methods: A retrospective review was conducted of all patients who underwent repair of congenital diaphragmatic hernia from January 1994 to May 2009.Results: Of the 155 patients included in the study, 101 patients had primary closure and 54 received a diaphragmatic patch. The rates of recurrence, Small Bowel Obstruction (SBO), and subsequent abdominal operation were all significantly higher in the group of patients requiring patch repair. There were 3 types of patch repairs: 37 patients received a SIS patch, 12 had a nonabsorbable patch, and 5 received an AlloDerm patch. The incidence of SBO in patients with a nonabsorbable mesh was 17% and was associated with a 50% recurrence rate and 67% re-recurrence rate. SIS was associated with 19% incidence of SBO, a recurrence rate of 22% and a 50% re-recurrence rate, whereas AlloDerm had a 40% incidence of SBO, 40% recurrence rate, and 100% re-recurrence rate.Discussion: As we move towards the next generation of materials, these data do not justify the continued comparison with nonabsorbable patches. We do not have enough comparative data to define a superior biosynthetic material, but we plan to use our data on SIS to benchmark our experience with future generation materials.