Delibegovic Samir, Koluh Anhel, Cickusic Elmir, Katica Muhamed, Mustedanagic Jasminka, Krupic Ferid
a Department of Surgery , University Clinical Centre , Tuzla , Bosnia and Herzegovina.
b Faculty of Medicine , University of Tuzla , Tuzla, Bosnia and Herzegovina.
Acta Chir Belg. 2016 Oct;116(5):293-300. doi: 10.1080/00015458.2016.1179513. Epub 2016 Jun 2.
After laparoscopic repair of an incisive hernia, intraperitoneal prosthetic mesh, as a foreign material, is a strong stimulus for the development of adhesion, which may be the cause of serious complications. This experimental study compared three different meshes and their ability to prevent the formation of adhesion and shrinkage.
Ninety rats were divided randomly into three groups: in Group 1 Proceed mesh was implanted, in Group 2 Ultrapro mesh was implanted, and in Group 3 TiMesh was implanted. Mesh samples were fixed as an intraabdominal mesh in the upper part of the abdomen. Ten animals from each group were sacrificed on days 7, 28 and 60 post-surgery. After opening the abdomen, the formation of adhesion was assessed according to the Surgical Membrane Study Group (SMSG) score, the percentage of shrinkage of the mesh was established and inflammatory reaction scored.
The SMSG score for adhesion was statistically significantly higher on all the postoperative days in the Proceed and Ultrapro mesh groups than in the TiMesh group which caused milder inflammatory reaction on 60th day than others meshes. The size of the mesh after 7 days was statistically significantly smaller in the Proceed and Ultrapro groups than in the TiMesh group, but after 60 days it was statistically significantly larger than in the TiMesh group.
The least formation of adhesion was noted in the TiMesh group, in which the highest level of shrinkage was noticed after 28 and 60 days. TiMesh has advantages over the other meshes studied, but a larger size mesh may be recommended for intraperitoneal application.
腹腔镜下切开疝修补术后,腹腔内植入的人工合成补片作为一种异物,是导致粘连形成的强烈刺激因素,而粘连可能是严重并发症的原因。本实验研究比较了三种不同的补片及其预防粘连形成和收缩的能力。
将90只大鼠随机分为三组:第1组植入Proceed补片,第2组植入Ultrapro补片,第3组植入TiMesh补片。将补片样本作为腹腔内补片固定于上腹部。每组10只动物在术后第7天、第28天和第60天处死。打开腹腔后,根据手术膜研究组(SMSG)评分评估粘连形成情况,确定补片收缩百分比并对炎症反应进行评分。
Proceed补片组和Ultrapro补片组术后各天的粘连SMSG评分在统计学上均显著高于TiMesh组,且TiMesh组在第60天时引起的炎症反应比其他补片组更轻。Proceed补片组和Ultrapro补片组术后7天补片尺寸在统计学上显著小于TiMesh组,但术后60天时则显著大于TiMesh组。
TiMesh组粘连形成最少,且在术后28天和60天时收缩程度最高。TiMesh比所研究的其他补片具有优势,但对于腹腔内应用,可能建议使用尺寸更大的补片。