[Successful Biocompatible Treatment of Diaphragmatic Hernia in a Rat Model]

Treatment of major congenital diaphragmatic hernia (CDH) is a challenging task in paediatric surgery. Gore-Tex^® is now commonly used to treat CDH, but it carries the risk of recurrences, infections and other complications. The aim of our study was to analyse to what extent Lyoplant^® - an acellular, avascular biocompatible collagen mesh - is suitable for CDH in the rat model.

A median laparotomy was performed in young Wistar Furth rats with a body weight of 155 - 205 g. A defect was created by excising a 1.0 × 1.0 cm muscular segment of the left diaphragm, which was closed by implanting a PTFE mesh (n = 5), or a Lyoplant mesh (n = 6). For control purposes (sham group, n = 2), the defect was closed directly. Each rat was examined frequently for the duration of 12 weeks. After this period, the abdomen was reopened, examined for adhesions and the left diaphragm was explanted for histological examination.

All operated Wistar Furth rats exhibited a physiological body weight gain after the procedure. During the above period, no recurrence of CDH could be found, either radiologically or clinically. In all animals (PTFE vs. Lyoplant vs. sham group), strong adhesions of the left liver lobe to the implanted material were found. In contrast to the PTFE mesh, constant tissue remodeling and continuous neovascularisation were found in the Lyoplant group.

Our results show that Lyoplant can successfully be used for the biocompatible therapy of CDH in the rat model. The extent to which it can also be used to treat congenital diaphragmatic defects must be demonstrated by further experimental and clinical studies.