Abstract
BackgroundWe used GORE DUALMESH for the reconstruction of diaphragms in patients with thoracic malignancies. Here, we report the results.MethodsBetween July 2015 and August 2017, diaphragm reconstruction using 2-mm GORE DUALMESH was performed in 7 patients undergoing surgical resection for thoracic malignancies. After resection of the diaphragm, the mesh was trimmed to the size of defect and placed with the smooth surface facing the chest cavity and the rough surface facing the abdomen. It was fixed with interrupted sutures consisting of synthetic monofilament nonabsorbable 1–0 to 2 threads.ResultsIndications for resection were malignant pleural mesothelioma and primary lung cancer in 5 and 2 patients, respectively. Patients with malignant pleural mesothelioma underwent pleurectomy with decortication; patients with primary lung cancer underwent lung lobectomy. Right and left diaphragm reconstruction was performed for 4 and 3 patients, respectively. Neither complications related to diaphragm reconstruction nor displacement of mesh occurred during a follow-up period ranging from 11 days to 37 months.ConclusionsGORE DUALMESH is a good synthetic material for diaphragm reconstruction, because its smooth surface prevents adhesions to the lung and its rough surface allows adherence to abdominal tissue.
Highlights
We used GORE DUALMESH for the reconstruction of diaphragms in patients with thoracic malignancies
GORE DUALMESH has been successfully used for the repair and reconstruction of the abdominal wall and for procedures correcting a ventral hernia or large hiatus hernia.3–6) GORE DUALMESH was recently used for chest wall reconstruction.7–10)
Right diaphragm reconstruction was performed for 4 patients and left diaphragm reconstruction was performed for 3 patients
Summary
We used GORE DUALMESH for the reconstruction of diaphragms in patients with thoracic malignancies. Diaphragm resections are sometimes performed for tumors involving the diaphragm such as malignant pleural mesothelioma and primary lung cancer. Diaphragm reconstruction is performed to avoid respiratory compromise and the displacement of abdominal contents into the chest. Depending on the extent of resection, the diaphragm is sutured only or reconstructed using synthetic material or autologous tissues.1) Synthetic material is often used for large defects. L. Gore & Associates, Flagstaff, AZ) consists of PTFE sheets with 2 different surfaces.2) One surface is smooth and the other is rough. The smooth surface has a microporous surface and is intended not to adhere to the adjacent organ. The rough surface has a macroporous surface and is intended to adhere to the surrounding tissue by allowing in-growth of fibrous tissue. GORE DUALMESH has been successfully used for the repair and reconstruction of the abdominal wall and for procedures correcting a ventral (incisional) hernia or large hiatus hernia.3–6) GORE DUALMESH was recently used for chest wall reconstruction.7–10)
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