Dolce Charles J, Keller Jennifer E, Stefanidis Dimitrios, Walters K Christian, Heath Jessica J, Lincourt Amy L, Norton H James, Kercher Kent W, Heniford B Todd
Carolinas Medical Center, Charlotte, NC 28203, USA.
Surg Innov. 2012 Sep;19(3):295-300. doi: 10.1177/1553350611429115. Epub 2011 Dec 4.
Laparoscopic ventral hernia repair requires placement of an intraperitoneal prosthetic. Composite mesh types have been developed to address the shortcomings of standard meshes. The authors evaluated the host reaction to intraperitoneal placement of a novel composite material.
A comparison of an innovative polypropylene/polylactide composite mesh was made to parietex composite (PCO), Proceed, and DualMesh. Eighteen meshes per group were implanted on intact peritoneum in New Zealand white rabbits. The main outcome measures included the formation of visceral adhesions, adhesion tenacity, tensiometric measurements, and histological analysis. Evaluations of adhesions were made at 1, 4, and 16 weeks using a 2-mm minilaparoscopy.
There were no significant differences in the mean adhesion scores between the composite mesh types at week 1 (P = .15) and week 16 (P = .06). At 4 weeks, PCO had significantly fewer adhesions when compared with the other 3 mesh types (P = .02). Adhesion tenacity was also equivalent within the group at 16 weeks (P = .06). Tensiometry and histological analysis revealed no statistically significant differences between the mesh types.
Four different composite mesh types had equivalent intra-abdominal soft tissue attachments in a rabbit model after a 16-week implantation period. PCO demonstrated the lowest mean adhesion score of each mesh type. Each mesh exhibited equivalent stiffness and energy to failure after explantation. The 4 composite mesh types demonstrated the successful formation of a neoperitoneum and comparable host biocompatibility as evidenced by similar degrees of inflammation.
腹腔镜腹疝修补术需要放置腹腔内假体。已经开发出复合网片类型以解决标准网片的缺点。作者评估了宿主对一种新型复合材料腹腔内放置的反应。
将一种创新的聚丙烯/聚乳酸复合网片与 Parietex 复合网片(PCO)、Proceed 网片和 DualMesh 网片进行比较。每组 18 片网片植入新西兰白兔的完整腹膜上。主要观察指标包括内脏粘连的形成、粘连强度、张力测量和组织学分析。在 1、4 和 16 周时使用 2 毫米微型腹腔镜对粘连情况进行评估。
在第 1 周(P = .15)和第 16 周(P = .06)时,复合网片类型之间的平均粘连评分无显著差异。在第 4 周时,与其他 3 种网片类型相比 PCO 的粘连明显更少(P = .02)。在第 16 周时组内粘连强度也相当(P = .06)。张力测量和组织学分析显示网片类型之间无统计学显著差异。
在 16 周植入期后,四种不同的复合网片类型在兔模型中具有等效的腹腔内软组织附着情况。PCO 在每种网片类型中显示出最低的平均粘连评分。每种网片在取出后表现出等效的刚度和破坏能量。四种复合网片类型均成功形成了新腹膜,并且炎症程度相似证明具有相当的宿主生物相容性。