Rossi Lucas Félix, Trindade Manoel Roberto Maciel, D Acampora Armando José, Meurer Luise
Center for Experimental Research, Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil.
Arq Bras Cir Dig. 2017 Apr-Jun;30(2):77-82. doi: 10.1590/0102-6720201700020001.
Hernia correction is a routinely performed treatment in surgical practice. The improvement of the operative technique and available materials certainly has been a great benefit to the quality of surgical results. The insertion of prostheses for hernia correction is well-founded in the literature, and has become the standard of treatment when this type of disease is discussed.
To evaluate two available prostheses: the polypropylene and polypropylene coated ones in an experimental model.
Seven prostheses of each kind were inserted into Wistar rats (Ratus norvegicus albinus) in the anterior abdominal wall of the animal in direct contact with the viscera. After 90 days follow-up were analyzed the intra-abdominal adhesions, and also performed immunohistochemical evaluation and videomorphometry of the total, type I and type III collagen. Histological analysis was also performed with hematoxylin-eosin to evaluate cell types present in each mesh.
At 90 days the adhesions were not different among the groups (p=0.335). Total collagen likewise was not statistically different (p=0.810). Statistically there was more type III collagen in the coated polypropylene group (p=0.039) while type I was not different among the prostheses (p=0.050). The lymphocytes were statistically more present in the polypropylene group (p=0.041).
The coated prosthesis was not different from the polypropylene one regarding the adhesion. Total and type I collagen were not different among the groups, while type III collagen was more present on the coated mesh. There was a greater number of lymphocytes on the polypropylene mesh.
疝修补术是外科手术中常规进行的治疗方法。手术技术和可用材料的改进无疑极大地提高了手术效果的质量。在疝修补术中使用假体有充分的文献依据,并且在讨论这类疾病时已成为治疗标准。
在实验模型中评估两种可用的假体:聚丙烯假体和涂覆聚丙烯的假体。
将每种类型的七个假体植入Wistar大鼠(白化大鼠)的前腹壁,使其直接与内脏接触。经过90天的随访,分析腹腔内粘连情况,并对总胶原蛋白、I型和III型胶原蛋白进行免疫组织化学评估和视频形态测量。还用苏木精-伊红进行组织学分析,以评估每个网片中存在的细胞类型。
90天时,各组之间的粘连情况无差异(p = 0.335)。总胶原蛋白同样无统计学差异(p = 0.810)。统计学上,涂覆聚丙烯组中的III型胶原蛋白更多(p = 0.039),而假体之间的I型胶原蛋白无差异(p = 0.050)。聚丙烯组中的淋巴细胞在统计学上更多(p = 0.041)。
在粘连方面,涂覆假体与聚丙烯假体无差异。各组之间的总胶原蛋白和I型胶原蛋白无差异,而涂覆网片上的III型胶原蛋白更多。聚丙烯网片上的淋巴细胞数量更多。