Suture or prosthetic reconstruction of experimental diaphragmatic defects - Respiratory repercussions

Objective: Diaphragmatic reconstruction may cause several respiratory chang es, The aims of the present study were to evaluate the respiratory changes induced by two methods of diaphragmatic reconstruction. Methods: Two groups of rats with an experimental diaphragmatic defect were studied. In one group (n = 5), diaphragmatic resection was followed by stit ching together the borders of the wound (SUT); in another group (n = 5), th e defect was repaired by suturing in a polytetrafluoroetlylene (PTFE) patch . All animals were sedated, anesthetized, paralyzed, and mechanically venti lated, Spirometry, respiratory mechanics, and thoracoabdominal morphometry were evaluated before and after diaphragmatic reconstruction. Results: The suture of the diaphragm significantly decreased FVC and FEV1, and increased respiratory system, lung, and chest wall static and dynamic e lastances and viscoelastic/inhomogeneous pressures in relation to their res pective control values. On the other hand, diaphragmatic reconstruction wit h PTFE increased only respiratory system, lung, and chest wall static elast ances. In addition, respiratory system, pulmonary, and chest wall viscoelas tic/inhomogeneous pressures and dynamic elastances, as well as respiratory system and lung elastances, were significantly greater in SUT than in PTFE, Lateral diameter at the level of the xiphoid and cephalocaudal pulmonary d iameter diminished only in the SUT group. Conclusions: The reconstruction of the diaphragm with PTFE might be preferr ed to simple suture for surgical repair of large diaphragmatic defects, at least from a mechanical standpoint.