Yang J F, Han J S, Zhang K, Yao Y, Wang Y T
Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing 100191, China.
Zhonghua Fu Chan Ke Za Zhi. 2020 Feb 25;55(2):120-124. doi: 10.3760/cma.j.issn.0529-567X.2020.02.011.
To assess surgical outcomes of implanted porcine small intestinal submucosa (SIS) mesh in the rabbit vesicovaginal space (VVS) and explore its application value in pelvic floor reconstruction surgery. Sixteen male rabbits were randomly divided into four groups, and each group had four rabbits. All groups of rabbits were implanted with SIS mesh in the vesicovaginal space. They were humanely killed after a postoperative period of 7, 30, 90 and 180 days by group. The grafted area was removed with the surrounding bladder and vaginal tissues. The specimens were embedded in paraffin and then stained with HE and Masson's trichrome stains for visual observations, cells counts, and assessment of tissues and collagen fibers. (1) After HE staining, a large number of inflammatory response cells mainly eosinophils and lymphocytes infiltrated around the SIS mesh in 7 days group, and neovascularization was observed, the infiltration area of inflammatory response cells further increased in 30 days group, the infiltration area of inflammatory response cells significantly reduced in 90 days group, while the inflammatory response basically subsided in 180 days group. (2) After Masson's trichromestaining, the collagen structure of SIS mesh in 7 days group was clear and intact. While, the collagen structure of SIS mesh was partially degraded in 30 days group, the SIS meshes of 4 rabbits were completely degraded, but the collagen fragments of SIS remained in 90 days group. In 180 days group, the SIS mesh of all rabbits was degraded, and one of them had the formation of new collagen fibers. SIS mesh implanted into the VVS of rabbits can lead to a transient non infective inflammatory reaction, which could be completely degraded and a small amount of new collagen fibers could be produced after 180 days of implantation. Which shown that SIS mesh should be used cautiously in pelvic floor reconstruction surgery.
评估植入猪小肠黏膜下层（SIS）补片于兔膀胱阴道间隙（VVS）的手术效果，并探讨其在盆底重建手术中的应用价值。将16只雄性兔随机分为4组，每组4只。所有组的兔均在膀胱阴道间隙植入SIS补片。术后7、30、90和180天按组将兔人道处死。将移植区域连同周围的膀胱和阴道组织一起切除。标本用石蜡包埋，然后进行苏木精-伊红（HE）染色和马松三色染色，用于肉眼观察、细胞计数以及组织和胶原纤维评估。（1）HE染色后，7天组SIS补片周围有大量主要为嗜酸性粒细胞和淋巴细胞的炎性反应细胞浸润，并观察到新生血管形成，30天组炎性反应细胞浸润面积进一步增加，90天组炎性反应细胞浸润面积显著减少，而180天组炎性反应基本消退。（2）马松三色染色后，7天组SIS补片的胶原结构清晰完整。而30天组SIS补片的胶原结构部分降解，4只兔的SIS补片完全降解，但90天组仍有SIS的胶原碎片残留。180天组所有兔的SIS补片均降解，其中1只兔有新胶原纤维形成。植入兔VVS的SIS补片可导致短暂的非感染性炎性反应，植入180天后可完全降解并产生少量新胶原纤维。这表明SIS补片在盆底重建手术中应谨慎使用。
