Prosthetic patches used to close congenital diaphragmatic defects behave well: a long-term follow-up study.

To answer the question of what happens with time with prosthetic patches inserted to close a congenital diaphragmatic hernia, a retrospective study concerning the period 1982-1993 was undertaken. Thirty children received patch reconstruction. None of these patients had agenesis of the diaphragm. Early patch-related complications did not occur, but seven patients died shortly after the operation as a result of lung hypoplasia. Twenty-three patients with patch reconstruction of the diaphragm survived and were followed for a median period of 60 months. Patch-related complications occurred in two: one had a recurrence of the hernia at three months of age, requiring reinsertion of a patch, and one developed a patch abcess at the age of two years, requiring patch removal. Major thoracic wall deformities did not occur, but none of the patients had agenesis of the diaphragm. It is concluded that prosthetic patches used to close congenital diaphragmatic defects behave well.