Newly Designed Bioabsorbable Substitute for the Treatment of Diaphragmatic Defects

Overview

Journal Surg Today

Specialty General Surgery

Date 2012 Nov 20

PMID 23161480

Citations 4

Authors

Masayasu Aikawa

Mitsuo Miyazawa

Kojun Okamoto

Yasuko Toshimitsu

Katsuya Okada

Naoe Akimoto

Yosuke Ueno

Isamu Koyama

Yoshito Ikada

Affiliations

Soon will be listed here.

Abstract

Purpose: 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.

Citing Articles

Surgical management of the diaphragmatic defect in congenital diaphragmatic hernia: a contemporary review.

Jank M, Boettcher M, Keijzer R World J Pediatr Surg. 2024; 7(3):e000747.

PMID: 39183804 PMC: 11340723. DOI: 10.1136/wjps-2023-000747.

Diaphragmatic hernia repair porcine model to compare the performance of biodegradable membranes against Gore-Tex.

Scuglia M, Frazao L, Miranda A, Martins A, Barbosa-Sequeira J, Coimbra D Pediatr Surg Int. 2023; 40(1):7.

PMID: 37999778 PMC: 10673990. DOI: 10.1007/s00383-023-05584-x.

A growing animal model for neonatal repair of large diaphragmatic defects to evaluate patch function and outcome.

Eastwood M, Joyeux L, Pranpanus S, van der Merwe J, Verbeken E, De Vleeschauwer S PLoS One. 2017; 12(3):e0174332.

PMID: 28358826 PMC: 5373533. DOI: 10.1371/journal.pone.0174332.

Diaphragm Repair with a Novel Cross-Linked Collagen Biomaterial in a Growing Rabbit Model.

Mayer S, Decaluwe H, Ruol M, Manodoro S, Kramer M, Till H PLoS One. 2015; 10(7):e0132021.

PMID: 26147985 PMC: 4493058. DOI: 10.1371/journal.pone.0132021.

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