新型复合网片在胸壁重建中的特性：一项比较性动物研究。
Properties of novel composite meshes in chest wall reconstruction: A comparative animal study.
机构信息
Division of Cardiothoracic Surgery, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany.
Division of Cardiac, Thoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany.
出版信息
Ann Thorac Med. 2014 Jul;9(3):158-61. doi: 10.4103/1817-1737.134071.
PURPOSE
Novel composite meshes routinely used in laparoscopic hernia repair reportedly lead to fewer and less dense visceral adhesions and may provide a viable alternative in thoracic surgery as well.
METHODS
A total of 15 adult domestic pigs underwent full thickness chest wall resection and reconstruction with Parietene (polypropylene composite; PTE, n = 5), Parietex (polyester composite; PTX, n = 5) or Bard (purely polypropylene, n = 5) mesh. After an observation period of 90 days all animals were sacrificed, intrathoracic adhesions classified via thoracoscopy (VATS), meshes explanted and peak peal strength required for lung/mesh separation recorded.
RESULTS
Adhesions assessed through VATS-exploration were strongest in the PTX-Group while PTE and BM showed comparable results. Tensiometric analyses of peak peal strength confirmed lower values in BM than for PTE and PTX. Both composite materials showed good overall bioincorporation with post-surgical perigraft-fibrosis being strongest in BM.
CONCLUSION
We consider composite grafts a suitable alternative for chest wall reconstruction. They are characterized by good overall biointegration and limited perigraft-fibrosis, thus potentially facilitating redo-procedures, even though a hydrophilic coating per se does not appear to prevent intrathoracic adhesion formation.
目的
据报道，新型复合网片常用于腹腔镜疝修补术，可导致更少且更稀疏的内脏粘连，在胸外科中也可能是一种可行的替代方法。
方法
总共 15 只成年家猪进行全层胸壁切除和重建，使用 Parietene（聚丙烯复合材料；PTE，n = 5）、Parietex（聚酯复合材料；PTX，n = 5）或 Bard（纯聚丙烯，n = 5）网片。观察期 90 天后，所有动物均被处死，通过胸腔镜（VATS）对胸腔内粘连进行分类，取出网片，并记录肺/网片分离所需的最大峰值剥离强度。
结果
通过 VATS 探查评估的粘连在 PTX 组最强，而 PTE 和 BM 则显示出类似的结果。最大峰值剥离强度的张力分析证实，BM 的峰值剥离强度值低于 PTE 和 PTX。两种复合材料均表现出良好的整体生物整合性，BM 的围网纤维化最强。
结论
我们认为复合移植物是胸壁重建的一种合适的替代方法。它们的特点是整体生物整合性良好，围网纤维化有限，因此即使亲水涂层本身似乎不能防止胸腔内粘连的形成，也有可能便于再次手术。
Zotero 插件