Department of Cancer and Thoracic Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan.
Surg Today. 2011 Nov;41(11):1512-8. doi: 10.1007/s00595-010-4520-9. Epub 2011 Oct 4.
The biological responses to mesh in vivo have been evaluated in some papers, but the in vivo condition of mesh and plugs have not been sufficiently evaluated. This study evaluated the endoscopic observations and histological assessments of mesh plugs using swine models.
An artificial abdominal hernia was established in the porcine abdomen, and repaired using three different sizes of two types of plug, Proloop (ATRIUM Medical Corporation, Hudson, NH, USA) or Perfix (BARD Medical Division, Covington, GA, USA). The in vivo conditions of each plug were periodically observed using a laparoscope. Moreover, a histological evaluation of the plugs was performed 3 months after implantation.
The laparoscopic observation revealed that inversion of the plugs occurred in 10 out of 18 cases repaired with Perfix, while no case repaired with Proloop inverted. The large and medium sizes of Perfix plugs were inclined by an average of more than 30°. In addition, the triangular shape of Perfix plugs was broken and the vertical/horizontal ratio was enlarged during the observation period, while Proloop plugs shrank both vertically and horizontally. The inflammatory cell count was significantly lower within the Proloop plugs than within Perfix plugs.
Proloop plugs are apparently superior because they are stable even 3 months after implantation.
已有一些文献评估了网片在体内的生物学反应，但对网片和补片的体内情况尚未进行充分评估。本研究采用猪模型评估了网塞的内镜观察和组织学评估。
在猪腹部建立人工腹壁疝，并使用两种不同类型的两种塞子（Proloop，ATRIUM Medical Corporation，Hudson，NH，USA）或 Perfix（BARD Medical Division，Covington，GA，USA）对其进行修复。使用腹腔镜定期观察每个塞子的体内情况。此外，在植入 3 个月后对塞子进行组织学评估。
腹腔镜观察显示，使用 Perfix 修复的 18 例中有 10 例出现塞子反转，而使用 Proloop 修复的无一例出现反转。Perfix 塞子的大、中号平均倾斜超过 30°。此外，在观察期间，Perfix 塞子的三角形形状被打破，垂直/水平比增大，而 Proloop 塞子则垂直和水平收缩。Proloop 塞子内的炎症细胞计数明显低于 Perfix 塞子内。
Proloop 塞子明显更优越，因为即使在植入 3 个月后仍保持稳定。
