Autor(es):
Scuglia, Marianna ; Frazão, Laura P. ; Miranda, Alice Augusta Macedo ; Martins, Albino ; Barbosa-Sequeira, Joana ; Coimbra, Diana ; Longatto, Adhemar ; Reis, R. L. ; Silva, Cristina Isabel Nogueira ; Neves, N. M. ; Correia-Pinto, Jorge
Data: 2024
Identificador Persistente: https://hdl.handle.net/1822/87359
Origem: RepositóriUM - Universidade do Minho
Assunto(s): Congenital diaphragmatic hernia repair; Decellularized human chorion membrane; Electrospun fibrous mesh; Gore-Tex®; Thoracoscopic surgery
Descrição
Background Patch repair of congenital diaphragmatic hernia (CDH) using Gore-Tex® is associated with infection, adhesions, hernia recurrence, long-term musculoskeletal sequels and poor tissue regeneration. To overcome these limitations, the performance of two novel biodegradable membranes was tested to repair CDH in a growing pig model. Methods Twelve male pigs were randomly assigned to 3 diferent groups of 4 animals each, determined by the type of patch used during thoracoscopic diaphragmatic hernia repair (Gore-Tex®, polycaprolactone electrospun membrane-PCLem, and decellularized human chorion membrane-dHCM). After 7 weeks, all animals were euthanized, followed by necropsy for diaphragmatic evaluation and histological analysis. Results Thoracoscopic defect creation and diaphragmatic repair were performed without any technical difculty in all groups. However, hernia recurrence rate was 0% in Gore-Tex®, 50% in PCLem and 100% in dHCM groups. At euthanasia, Gore-Tex® patches appeared virtually unchanged and covered with a fbrotic capsule, while PCLem and dHCM patches were replaced by either foppy connective tissue or vascularized and foppy regenerated membranous tissue, respectively. Conclusion Gore-Tex® was associated with a higher survival rate and lower recurrence. Nevertheless, the proposed biodegradable membranes were associated with better tissue integration when compared with Gore-Tex®.
