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首页> 外文期刊>Surgical Endoscopy >A lightweight polypropylene mesh (TiMesh) for laparoscopic intraperitoneal repair of abdominal wall hernias: comparison of biocompatibility with the DualMesh in an experimental study using the porcine model.
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A lightweight polypropylene mesh (TiMesh) for laparoscopic intraperitoneal repair of abdominal wall hernias: comparison of biocompatibility with the DualMesh in an experimental study using the porcine model.

机译：用于腹腔镜腹腔疝腹腔镜修复的轻质聚丙烯网（TiMesh）：在使用猪模型的实验研究中，生物相容性与DualMesh的比较。

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BACKGROUND: Despite numerous experimental studies, conducted most often with the open small-animal model, the ideal structure for a mesh with maximum biocompatibility in the intraabdominal region has yet to be found. To date, few experimental models have been concerned with the laparoscopic intraabdominal implantation of meshes. Numerous experimental and clinical studies appear to have identified expanded polytetrafluoroethylene (ePTFE), in the form of DualMesh, as the gold standard. Since publications have reported fistula formation and marked adhesions to be associated with the use of polypropylene meshes, only few studies have investigated meshes made of this material. It is known, however, that a reduction in the amount of material and an increase in pore size results in better mesh biocompatibility. METHODS: Six pigs each underwent laparoscopic intraabdominal placement of either a TiMesh or a DualMesh, both of which were prepared for implantation in standardized fashion. After 87 +/- 2 days, the pigs were killed, and postmortem laparoscopy was performed, followed by the removal of the tissue embedding the mesh for assessment of adhesions and shrinkage, and for histologic workup. The specimens were processed both histologically and immunohistochemically. RESULTS: In all but one case, the greater omentum adhered, usually over discrete areas, to the mesh. In every case the omentum was separable from the mesh surface only by sharp dissection. With the titanium-coated polypropylene meshes, the average total adhesion area was only 0.085, as compared with 0.25 for the GoreTex meshes (p = 0.055). The GoreTex meshes showed an average shrinkage to almost half of the original surface area (median, 0.435). The average shrinkage of the TiMesh, was to 0.18 of the original area (p = 0.006), which thus was significantly smaller. Determination of the partial volume of the inflammatory cells showed significantly lower median figures for the TiMesh (p = 0.009). Measurements of the proliferation marker Ki67 showed significantly higher values for ePTFE than for TiMesh (p = 0.011). The apoptosis index was significantly higher for the ePTFE membranes (p = 0.002). CONCLUSIONS: Titanium-coated polypropylene mesh (TiMesh) is clearly superior to the DualMesh in terms of biocompatibility, and is thus suitable for the laparoscopic intraperitoneal repair of abdominal wall and incisional hernias.
机译：背景：尽管进行了大量的实验研究，最常使用开放式小动物模型进行研究，但尚未找到在腹腔内具有最大生物相容性的网状结构的理想结构。迄今为止，很少有实验模型与腹腔镜腹腔内植入网有关。大量的实验和临床研究似乎都已将以DualMesh形式出现的膨化聚四氟乙烯（ePTFE）确定为金标准。由于出版物已经报道了与聚丙烯网的使用相关的瘘管形成和明显的粘连，因此只有很少的研究调查了这种材料制成的网。然而，已知减少材料量和增加孔径会导致更好的网孔生物相容性。方法：对六头猪进行腹腔镜腹腔内TiMesh或DualMesh放置，均准备好以标准化方式植入。在87 +/- 2天后，将猪处死，进行死后腹腔镜检查，然后去除包埋网孔的组织，以评估粘连和皱缩以及进行组织学检查。对标本进行组织学和免疫组织化学处理。结果：除一种情况外，大网膜通常在离散区域粘附在网片上。在每种情况下，大网膜只能通过锐利的解剖与网状表面分开。使用钛涂层聚丙烯网片时，平均总粘合面积仅为0.085，而GoreTex网片则为0.25（p = 0.055）。 GoreTex网格显示平均收缩率几乎是原始表面积的一半（中位数为0.435）。 TiMesh的平均收缩率为原始面积的0.18（p = 0.006），因此明显较小。测定炎性细胞的部分体积显示TiMesh的中位数显着降低（p = 0.009）。增殖标志物Ki67的测量显示ePTFE的值明显高于TiMesh（p = 0.011）。 ePTFE膜的凋亡指数明显更高（p = 0.002）。结论：钛涂层聚丙烯网（TiMesh）在生物相容性方面明显优于DualMesh，因此适用于腹腔镜腹膜内腹壁和切口疝的修复。

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