Thoracotomy patch repair of large diaphragmatic herniae in a porcine model: a tale of two patches.

Dermot T McDowell, Tegan Cheng, Alexandre Darani, Raf Dye, Susan Arbuckle, Ralph C Cohen

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Article in Pediatric surgery international, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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6 authors.

Dermot T McDowellDivision of Child and Adolescent Health, Sydney Medical School, The University of Sydney, Sydney, Australia.

Tegan ChengEPIC Lab, The Children's Hospital at Westmead, Sydney, Australia.

Alexandre DaraniDepartment of Paediatric Surgery, The Children's Hospital at Westmead, Sydney, Australia.

Raf DyeDepartment of Paediatric Surgery, The Children's Hospital at Westmead, Sydney, Australia.

Susan ArbuckleDepartment of Anatomical Pathology, The Children's Hospital at Westmead, Sydney, Australia.

Ralph C CohenDivision of Child and Adolescent Health, Sydney Medical School, The University of Sydney, Sydney, Australia. ralphcohen@bigpond.com.

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6 · The paper itself

Abstract

purposeCongenital diaphragmatic herniae (CDH) may require patch closure in 50% of the cases. We assessed a biologic and composite mesh in a porcine CDH model.

methodsLeft sided thoracotomy was performed in 20 pigs. Approximately, 30% of the diaphragm was excised and the patch (Surgisis® or Parietex®) inserted to close this defect. The pigs were killed at 6 months and the diaphragm was harvested for biomechanical and histological assessment.

resultsThe mean weight of the pigs at surgery and killing were 6.1 kg (4.2-8.4 kg) and 94.1 kg (80-131 kg), respectively. There were two recurrences and three eventrations, all with Surgisis®. There were less dense lung and abdominal adhesions in the Parietex group (P < 0.0001 and 0.025, respectively). The tensile strength of the Surgisis®, the Parietex® groups and controls were similar. There was significantly more muscle in-growth in the Parietex® patch over Surgisis® (p = 0.016).

conclusionParietex® and Surgisis® patches at 6 months have a similar tensile strength to normal tissue. All recurrences and eventrations were in the Surgisis® group. Parietex® patches demonstrated more muscle in-growth into the patch compared to Surgisis®. This is the first study utilising Parietex® composite patch in the repair of large diaphragmatic defects in a porcine model.

Indexed as

Disease Models, AnimalHernia, DiaphragmaticHernias, Diaphragmatic, CongenitalSurgical MeshThoracotomyAnimalsDiaphragmHerniorrhaphySwineTensile StrengthCongenital diaphragmatic herniaePatch repairRecurrenceTensile strength

Identifiers

PMID39531056

DOI10.1007/s00383-024-05893-9

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.