The Thoracic and Cardiovascular Surgeon. 2011 Feb;59(1):40-4. Epub 2011 Jan 17. [Link]
Zardo P, Zhang R, Wiegmann B, Haverich A, Fischer S.
Department of Thoracic Surgery and Lung Assist, Klinikum IbbenbÃ¼ren, IbbenbÃ¼ren, Germany.
Background: We sought to analyze the efficacy of a bovine pericardial patch (PeriGuardÂ®) for diaphragmatic repair.
Methods: Seven consecutive patients (6 males, median age 56 years) scheduled for diaphragmatic resection and/or repair were enrolled in this study. In all cases diaphragmatic repair was performed with a PeriGuard Repair PatchÂ® (Synovis, St.Â Paul, MN, USA). At follow-up (median: 12 months; range: 6-18 months), quality of life, signs of reherniation and incorporation of mesh were assessed through clinical examination, blood samples and CT or MRT scan.
Results: Diagnosis on admission included sarcoma (n = 2), mesothelioma (n = 1), squamous cell carcinoma (n = 1), parachordoma (n = 1) and large congenital or posttraumatic herniation (n = 2). At follow-up successful diaphragmatic repair with no signs of reherniation, graft dehiscence or seroma formation was confirmed for all patients. Recorded inflammatory markers [C-reactive protein (CRP), white blood cell count (WBC) and procalcitonin (PCT)] reached their peak values between postoperative day (POD) 4 and POD 7. Values ranged from 122-282 mg/L for CRP, 0.4-4.6 Âµg/L for PCT and 6.2-15.6 Tsd/ÂµL for WBC. Overall oncological results were good and 5 out of 6 survivors reported a fully reestablished quality of life.
Conclusion: We consider the PeriGuard Repair Patch® a viable alternative to synthetic materials for diaphragm replacement. Moreover, we advise carrying out cautious follow-up in patients undergoing extensive oncological resection to learn more about the biological behavior of the bovine PeriGuard Repair PatchÂ® after diaphragmatic repair.