Bekdash Basil, Singh Baljit, Lakhoo Kokila
J Med Case Rep. 2009 May 26;3:7237. doi: 10.1186/1752-1947-3-7237.
Many different prosthetic materials have been used for repair of large posterolateral congenital diaphragmatic hernias, which cannot be primarily repaired. Almost 50% of patch repaired diaphragmatic hernias will recur. The ideal prosthetic material for congenital diaphragmatic hernia repair has yet to be established. We report on two cases with unusual (calcification) and late complications related to the prosthetic material used for diaphragmatic hernia repair.
We report two cases of antenatally diagnosed left-sided diaphragmatic hernia that were repaired with a patch due to total absence of a diaphragm. Both Caucasian patients developed recurrent late graft complications. Case one was repaired on day 17 post-stabilisation and developed recurrence at 14(1/2) months of age and again at 26 months of age. Case 2 underwent surgery on day 13 of life and developed recurrence at 4 months and again at 3 years of age. In the recurrent repairs, both synthetic and biomaterial patches were used. Both patients are well at long-term follow-up of 10 and 7 years, respectively.
The ideal choice of patch material for diaphragmatic hernia repair remains a therapeutic challenge.
许多不同的假体材料已被用于修复无法进行一期修复的大型后外侧先天性膈疝。几乎50%的使用补片修复的膈疝会复发。用于先天性膈疝修复的理想假体材料尚未确定。我们报告两例与用于膈疝修复的假体材料相关的不寻常（钙化）和晚期并发症的病例。
我们报告两例产前诊断为左侧膈疝的病例，由于完全没有膈肌，采用补片进行修复。两名白种人均出现复发性晚期移植物并发症。病例1在病情稳定后第17天进行修复，在14.5个月龄时复发，26个月龄时再次复发。病例2在出生后第13天接受手术，4个月时复发，3岁时再次复发。在复发性修复中，使用了合成补片和生物材料补片。两名患者分别在10年和7年的长期随访中情况良好。
膈疝修复补片材料的理想选择仍然是一个治疗挑战。
