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首页> 外文期刊>Surgical Endoscopy >Evaluation of adhesion formation, mesh fixation strength, and hydroxyproline content after intraabdominal placement of polytetrafluoroethylene mesh secured using titanium spiral tacks, nitinol anchors, and polypropylene suture or polyglactin 910 sutu
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Evaluation of adhesion formation, mesh fixation strength, and hydroxyproline content after intraabdominal placement of polytetrafluoroethylene mesh secured using titanium spiral tacks, nitinol anchors, and polypropylene suture or polyglactin 910 sutu

机译：评估腹腔内放置的钛钛螺旋钉，镍钛合金锚钉，聚丙烯缝合线或聚乳酸910 sutu固定的聚四氟乙烯网片后的粘附形成，网片固定强度和羟脯氨酸含量

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BACKGROUND: The purpose of this study is to evaluate fixation methods for polytetrafluoroethylene (ePTFE) mesh with an in vivo model of laparoscopic ventral hernia repair. METHODS: In 40 New Zealand white rabbits, a 4 x 4-cm ePTFE mesh (n = 80, two per animal) was attached to an intact peritoneum with polyglactin 910 (PG 910) (n = 20) or polypropylene (PP) (n 20) suture, titanium spiral tacks (TS) (n (n = 20). Mesh was harvested at 8 and 16 weeks for fixation strength testing, adhesion assessment, and collagen (hydroxyproline) content. Fixation strength on day 0 was determined with mesh attached to harvested abdominal wall. Statistical significance was determined as p < 0.05. RESULTS: There was no difference in fixation strength between PP (39.1 N) and PG 910 (40.0 N) sutures at time zero. At week 8, PP (25.7 N) was significantly stronger (p < 0.05) than PG 910 (11.4 N) suture, but not at week 16. The fixation strength of TS and NA (day 0, 15.4 vs 7.4 N; week 8, 17.5 vs 15.3 N; week 16, 19.1 vs 13.8 N)was not significantly different. Fixation with PP suture was significantly (p < 0.05) stronger than that with TS and NA at day 0 (39.1, 15.4, and 7.4 N, respectively) but not at weeks 8 or 16. The fixation strength of suture decreased significantly (p < 0.05) from day 0 to week 16 (PP: day 0 = 39.1 N, week 8 = 25.7 N, week 16 = 21.4 N; PG 910: day 0 = 40.0 N, week 8 = 11.4 N, week 16 = 12.8 N). The fixation strength of NA and TS did not change significantly (NA: day 0 7.4 N, week 8 17.5 N, week 16 = 19.1 N). There were no differences in adhesion area based on fixation device used; however, there were more (p < 0.05) mesh samples using NA with adhesions compared to TS and adhesion tenacity was greater (p < 0.05) compared to that of TS, PP, and PG. Hydroxyproline content at weeks 8 and 16 was similar for all fixation devices. CONCLUSIONS: The initial fixation strength for nonabsorbable suture is significantly greater than that of the metallic fixation devices, but after 8 weeks there is no difference. Laparoscopic ventral hernia repair without transabdominal suture fixation may be predisposed to acute failure. The metallic devices have similar fixation strength, although the incidence of adhesions and tenacity of adhesions appear to be greater with the nitinol anchors. Since these devices have similar fixation strengths and most likely provide adequate supplementation to transabdominal sutures for mesh fixation after laparoscopic ventral hernia repair, their use should be based on other factors, such as their propensity for adhesions, ease of application, and cost.
机译：背景：这项研究的目的是评估与腹腔镜腹侧疝修补术体内模型的聚四氟乙烯（ePTFE）网的固定方法。方法：在40只新西兰白兔中，将4 x 4厘米ePTFE筛网（n = 80，每只动物两只）附着在完整的腹膜上，并用聚乳酸910（PG 910）（n = 20）或聚丙烯（PP）（ n 20）缝线，钛螺旋钉（n = 20）。在第8和16周时收获网片用于固定强度测试，附着力评估和胶原蛋白（羟脯氨酸）含量。结果显示：PP（39.1 N）和PG 910（40.0 N）缝线在零时线的固定强度没有差异;在第8周，PP（25.7） N）比PG 910（11.4 N）缝合线强得多（p <0.05），但在第16周时没有。TS和NA的固定强度（第0天，15.4 vs 7.4 N;第8周，17.5 vs 15.3 N;周） 16、19.1和13.8 N）无显着差异，PP缝线在第0天（39.1、15.4和7.4 N）的固定效果显着（p <0.05）强于TS和NA从第0天到第16周（PP：第0天= 39.1 N，第8周= 25.7 N，第16周= 21.4 N;从第0天到第16周，缝合线的固定强度显着降低（p <0.05）。 PG 910：第0天= 40.0 N，第8周= 11.4 N，第16周= 12.8 N）。 NA和TS的固定强度没有明显变化（NA：第0天7.4 N，第8周17.5 N，第16周= 19.1 N）。根据使用的固定装置，附着面积没有差异。然而，与TS相比，使用NA的具有粘附力的NA样品数量更多（p <0.05），与TS，PP和PG相比，粘附强度更大（p <0.05）。所有固定装置在第8和16周的羟脯氨酸含量相似。结论：不可吸收缝合线的初始固定强度明显高于金属固定装置，但8周后没有差异。未经腹腔镜缝合固定的腹腔镜腹疝修补术可能会导致急性衰竭。金属装置具有相似的固定强度，尽管镍钛合金锚固件的粘附发生率和粘附强度似乎更大。由于这些装置具有相似的固定强度，最有可能在腹腔镜腹疝修补术后为经腹缝合提供足够的补充，以进行网状固定，因此，应根据其他因素（例如其粘附倾向，易于使用和成本）来使用它们。

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