Recurrent congenital diaphragmatic hernia: A novel repair

Background/Purpose: Repair of recurrent diaphragmatic hernia continues to be a difficult problem. An innovative method using a nonabsorbable polypropylene prosthetic mesh plug placed via the thoracic approach using minimal dissection is presented. Methods: A retrospective analysis showed 39 children...

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Bibliographic Details
Published in:Journal of pediatric surgery 2001-12, Vol.36 (12), p.1768-1769
Main Authors: Saltzman, Daniel A., Ennis, Jared S., Mehall, John R., Jackson, Richard J., Smith, Samuel D., Wagner, Charles W.
Format: Article
Language:English
Subjects:
Biological and medical sciences
Child, Preschool
Diaphragm - surgery
Hernia, Diaphragmatic - surgery
Hernias, Diaphragmatic, Congenital
Humans
Infant
Medical sciences
mesh plug hernioplasty
Polypropylenes - therapeutic use
Recurrence
Recurrent diaphragmatic hernia
Reoperation - methods
Retrospective Studies
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Surgery of the respiratory system
Surgical Mesh
Technology. Biomaterials. Equipments
Thoracotomy - methods
transthoracic repair
Treatment Outcome
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Summary:Background/Purpose: Repair of recurrent diaphragmatic hernia continues to be a difficult problem. An innovative method using a nonabsorbable polypropylene prosthetic mesh plug placed via the thoracic approach using minimal dissection is presented. Methods: A retrospective analysis showed 39 children with congenital diaphragmatic hernia (CDH) who underwent repair between January 1997 and March 2000. Five children suffered a recurrence and underwent repair via the thoracic approach using the Bard Marlex Mesh Perfix Plug (C.R. Bard Inc, Billerica, MA). Follow-up was available in all children and ranged from 1 to 33 months (average, 13.8 months). Results: Age at recurrence ranged from 2 to 48 months (average, 14.8 months), and the average time between initial repair and recurrence was 8.2 months (range, 2 to 16 months). There were no recurrences after the transthoracic mesh plug diaphragmatic hernioplasty. One child died of multiple congenital anomalies 6 months after repair. Conclusion: The transthoracic repair of recurrent diaphragmatic hernias using a nonabsorbable polypropylene prosthetic mesh plug represents an innovative approach to a difficult problem in which 5 repairs have been accomplished without recurrence in nearly 14 months of follow-up. J Pediatr Surg 36:1768-1769. Copyright © 2001 by W.B. Saunders Company.
ISSN:0022-3468
1531-5037
DOI:10.1053/jpsu.2001.28818