Lefort Bruno, El Arid Jean-Marc, Bouquiaux Anne-Lorraine, Soulé Nathalie, Chantreuil Julie, Tavernier Elsa, Chantepie Alain, Neville Paul
Children Hospital Gatien de Clocheville, Tours, France.
University François Rabelais, Tours, France.
J Cardiothorac Surg. 2015 Mar 31;10:47. doi: 10.1186/s13019-015-0257-2.
Morbidity and mortality are higher for cardiac reoperations than first operation due to the presence of post-operative adhesions. We retrospectively evaluated the efficacy of the bioresorbable membrane Seprafilm to prevent pericardial adhesions after cardiac surgery in a paediatric congenital heart disease population.
Seventy-one children undergoing reoperations with sternotomy redo and cardiopulmonary bypass for congenital malformations were included. Twenty-nine of these patients were reoperated after previous application of Seprafilm (treatment group). The duration of dissection, aortic cross clamping and total surgery were recorded. A tenacity score was established for each intervention from the surgeon's description in the operating report.
In multivariate analysis, the duration of dissection and the tenacity score were lower in the treatment than control group (p < 0.01), independent of age and interval since preceding surgery.
Our results suggest that Seprafilm is effective in reducing the post-operative adhesions associated with infant cardiac surgery. We recommend the use of Seprafilm in paediatric cardiac surgery when staged surgical interventions are necessary.
由于术后粘连的存在，心脏再次手术的发病率和死亡率高于首次手术。我们回顾性评估了生物可吸收膜Seprafilm在小儿先天性心脏病患者心脏手术后预防心包粘连的疗效。
纳入71例因先天性畸形接受胸骨切开再次手术和体外循环的儿童。其中29例患者在先前应用Seprafilm后接受再次手术（治疗组）。记录解剖时间、主动脉阻断时间和总手术时间。根据手术报告中外科医生的描述为每次干预建立一个坚韧度评分。
多因素分析显示，治疗组的解剖时间和坚韧度评分低于对照组（p < 0.01），与年龄和上次手术以来的间隔无关。
我们的结果表明，Seprafilm在减少与婴儿心脏手术相关的术后粘连方面是有效的。我们建议在需要分期手术干预时，在小儿心脏手术中使用Seprafilm。
