What is the best prosthetic material for patch repair of congenital diaphragmatic hernia? Comparison and meta-analysis of porcine small intestinal submucosa and polytetrafluoroethylene
What is the best prosthetic material for patch repair of congenital diaphragmatic hernia? Comparison and meta-analysis of porcine small intestinal submucosa and polytetrafluoroethylene
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DOI：
10.1016/j.jpedsurg.2012.01.009
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发表时间：
2012-08-01
影响因子：
2.4
通讯作者：
Langer, Jacob C.
中科院分区：
文献类型：
--
作者：
Romao, Rodrigo L. P.;Nasr, Ahmed;Langer, Jacob C.
背景：人工补片广泛应用于先天性膈疝（CDH）修复。我们比较了可吸收材料（Surgisis [SIS]; Cook Biotech, Inc ., West Lafayette， IN）和不可吸收材料（聚四氟乙烯[PTFE]）的并发症发生率。方法：对我院10年来所有接受补片闭合的新生儿CDH进行回顾性分析。我们还将我们的数据与研究贴片类型对复发和小肠梗阻（SBO）影响的已发表文献进行了meta分析。结果：84例CDH患者中22例（26%）进行了初级补片（13 SIS, 9 PTFE）修复。各组在人口统计学、住院时间、呼吸机天数、高频振荡需求、手术年龄和随访时间方面具有可比性。同样，复发率（SIS, 4 [31%]； PTFE, 3 [33%]； P，无统计学意义[NS]）、术后SBO发生率（SIS, 1 [7%] vs PTFE, 2 [22%]； P， NS）和死亡率（SIS， 2[15%]和PTFE， 2 [22%]； P， NS）相似。meta分析未发现SIS和PTFE在复发率（比值比，1.21 [0.51-2.84]；P， NS）和SBO（比值比，1.47 [0.44-4.96]；P， NS）方面存在显著差异。结论：在我们的研究中，使用SIS或PTFE进行CDH补片修复后，CDH的复发率、SBO或死亡率没有差异。meta分析未显示两种材料的复发率和SBO率有任何差异。(C) 2012爱思唯尔公司版权所有。
Background: Prosthetic patches are widely used for congenital diaphragmatic hernia (CDH) repair. We compared the complication rate of absorbable (Surgisis [SIS]; Cook Biotech, Inc, West Lafayette, IN) and nonabsorbable (polytetrafluoroethylene [PTFE]) materials for this purpose.Methods: This is a retrospective review of all neonates with CDH undergoing patch closure at our institution over 10 years. Meta-analysis was also performed combining our data with the published literature examining the effect of patch type on recurrence and small bowel obstruction (SBO).Results: Primary patch (13 SIS, 9 PTFE) repair was performed in 22 (26%) of 84 patients with CDH. Groups were comparable in terms of demographics, hospital stay, ventilator days, need for high frequency oscillation, age at surgery, and length of follow-up. Likewise, recurrence rate (SIS, 4 [31%]; PTFE, 3 [33%]; P, nonsignificant [NS]), incidence of postoperative SBO (SIS, 1 [7%] vs PTFE, 2 [22%]; P, NS), and mortality (SIS, 2 [15%] and PTFE, 2 [22%]; P, NS) were similar. Meta-analysis failed to find a significant difference between SIS and PTFE both for recurrence rate (odds ratio, 1.21 [0.51-2.84]; P, NS) and SBO (odds ratio, 1.47 [0.44-4.96]; P, NS).Conclusions: There was no difference in the incidence of CDH recurrence, SBO, or mortality post-CDH patch repair using either SIS or PTFE in our series. Meta-analysis failed to show any difference in recurrence and SBO rates between the 2 materials. (C) 2012 Elsevier Inc. All rights reserved.