Department of Surgery and Center of Minimally Invasive Surgery, Vivantes Hospital Spandau, Academic Teaching Hospital of Charité University Medicine, Neue Bergstraße 6, 13585, Berlin, Germany,
Hernia. 2014 Aug;18(4):445-57. doi: 10.1007/s10029-013-1187-3. Epub 2013 Nov 20.
Despite the vast selection of brands available, nearly all synthetic meshes for hernia surgery continue to use one or other of three basic materials: polypropylene, polyester and ePTFE. These are used in combination with each other or with a range of additional materials such as titanium, omega 3, monocryl, PVDF and hyaluronate. This systematic review of all experimental and clinical studies is aimed at investigating whether titanized meshes confer advantages over other synthetic meshes in hernia surgery.
A search of the medical literature from 2002 to 2012, as indexed by Medline, was performed, using the PubMed search engine (http://www.pubmed.gov). The search terms were: hernia mesh, titanium coating, lightweight mesh, TiMesh, mesh complications. All papers were graded according to the Oxford hierarchy of evidence.
Patients operated on with the Lichtenstein technique performed using the lightweight titanium-coated mesh have a shorter convalescence than those with the heavy-weight mesh Prolene. For inguinal hernias operated on with the TAPP technique and using a lightweight titanium-coated mesh in comparison to a heavy-weight Prolene mesh, the early postoperative convalescence seems to improve. Titanized meshes do exhibit a negative effect on sperm motility 1 year after a TEP operation, but not after 3 years. The laparoscopic IPOM technique with a titanium-coated polypropylene mesh was associated with less postoperative pain in the short term, lower analgesic consumption and a quicker return to everyday activities compared with the Parietex composite mesh.
In clinical studies, the titanium-coated polypropylene mesh shows in inguinal hernia repair certain benefits compared with the use of older heavy-weight meshes.
尽管有大量品牌可供选择，但几乎所有用于疝修补术的合成网片仍继续使用三种基本材料中的一种或另一种：聚丙烯、聚酯和膨体聚四氟乙烯。这些材料相互组合，或与一系列其他材料（如钛、欧米伽 3、单丝、PVDF 和透明质酸钠）组合使用。本系统评价对所有实验和临床研究进行综述，旨在研究钛化网片在疝修补术中是否优于其他合成网片。
使用 PubMed 搜索引擎（http://www.pubmed.gov）对 Medline 索引的 2002 年至 2012 年的医学文献进行了检索。检索词为：疝网片、钛涂层、轻质网片、TiMesh、网片并发症。所有论文均根据牛津证据等级进行分级。
与使用 Prolene 重质网片的患者相比，采用 Lichtenstein 技术并用轻质钛涂层网片进行手术的患者恢复期更短。与使用 Prolene 重质网片相比，采用 TAPP 技术并用轻质钛涂层网片进行腹股沟疝修补术的患者早期术后恢复期似乎有所改善。与 TEP 手术后使用 Prolene 重质网片相比，使用 TiMesh 对精子活力有负面影响，但在 3 年后无影响。与使用 Parietex 复合网片相比，腹腔镜 IPOM 技术联合使用钛涂层聚丙烯网片在短期内术后疼痛更少、镇痛药消耗更少、更快恢复日常活动。
在临床研究中，与使用旧的重质网片相比，钛涂层聚丙烯网片在腹股沟疝修补术中具有某些优势。
