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首页> 外文期刊>Surgical Endoscopy >Evaluation of DualMesh for repair of large hiatus hernia in a porcine model.
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Evaluation of DualMesh for repair of large hiatus hernia in a porcine model.

机译：评价DualMesh在猪模型中修复大裂孔疝的效果。

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BACKGROUND: Prosthetic fascial grafts are frequently used for augmentation of cruroplasty in large hiatus hernia repair to decrease the chances of recurrence. Potential complications such as intraluminal erosion may be related to the constant movement of mesh and diaphragm over the outer surface of the esophagus. This study aimed to evaluate DualMesh for repair of large hiatal defects in a porcine model. METHODS: In this study, 18 Landrace x large white x Duroc crossbred pigs underwent either primary hiatal repair or tension-free prosthetic repair using DualMesh (80 x 50 mm or 80 x 100 mm). The animals were killed at 3 or 28 weeks for macroscopic and histologic evaluation of the hiatal region and gastroesophageal junction. RESULTS: All grafts had become encapsulated at 28 weeks, and the majority had filmy adhesions only to the visceral aspect. In all models, the esophagus moved freely over the cut edge of the prosthesis. No signs of intraluminal erosion were documented. At histologic examination, significant ingrowth was noted on the porous side of the mesh, whereas no defined mesothelial layer was identified on the capsule of the nonporous side. CONCLUSION: In this animal model of large hiatus hernia repair, DualMesh showed optimal characteristics in terms of host tissue incorporation on the porous side and absence of adhesions on the visceral side of the prosthesis. The absence of adhesions and intraluminal erosion in this study may provide reassurance to surgeons using mesh at the hiatus.
机译：背景：人工筋膜筋膜移植通常用于大裂孔疝修补术中的强化成形术，以减少复发的机会。诸如腔内侵蚀的潜在并发症可能与网孔和隔膜在食道外表面的持续运动有关。这项研究旨在评估DualMesh在猪模型中修复大型裂孔缺损的可能性。方法：在本研究中，使用DualMesh（80 x 50 mm或80 x 100 mm）对18头Landrace x大白x Duroc杂种猪进行了基本的裂孔修复或无张力的假体修复。在3或28周时处死动物，以对其裂孔区域和胃食管连接处进行宏观和组织学评估。结果：所有移植物都在第28周被包封，并且大多数仅在内脏方面有膜状粘连。在所有模型中，食道都可以在假体的切割边缘上自由移动。没有文献记载管腔内糜烂的迹象。在组织学检查中，注意到在网孔的多孔侧上有明显的向内生长，而在无孔一侧的胶囊上未发现限定的间皮层。结论：在这种大裂孔疝修补术的动物模型中，DualMesh在宿主组织掺入到多孔体一侧且假体的内脏侧无粘附方面显示出最佳特性。这项研究中不存在粘连和管腔内糜烂，可为在裂孔处使用网状结构的外科医生提供放心。

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