Mesh migration into the esophageal wall after mesh hiatoplasty: comparison of two alloplastic materials View Full Text


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Article Info

DATE

2007-08-19

AUTHORS

M. Jansen, J. Otto, P. Lynen Jansen, M. Anurov, S. Titkova, S. Willis, R. Rosch, A. Öttinger, V. Schumpelick

ABSTRACT

BackgroundHiatal mesh implantation in the operative treatment of gastroesophageal reflux disease has become an increasing therapy option. Besides clinical results little is known about histological changes in the esophageal wall.MethodsTwo different meshes [polypropylene (PP), Prolene®; polypropylene–polyglecaprone 25 composite (PP–PG), Ultrapro®] were placed on the diaphragm circular the esophagus of 20 female rabbits. After three months a swallow with iodine water-soluble contrast medium for functional analysis was performed. After the animals were sacrificed, histopathological evaluation of the foreign-body reaction, the localization of the mesh relating to the esophageal wall was analyzed.ResultsSixteen rabbits survived the complete observation period of three months. After three months distinctive mesh shrinkage was observed in all animals and meshes had lost up to 50% of their original size before implantation. We found a delayed passage of the fluid into the stomach in all operated animals. There was a significant increased diameter of the outer ring of granulomas in the PP group (76.5 ± 8.0) compared to the PP–PG group (64 ± 8.5; p = 0.002). However, we found a mesh migration into the esophageal wall in six out of seven animals (PP) and five out of nine animals (PP-PG), respectively.ConclusionExperimental data suggest that more knowledge is necessary to assess the optimal size, structure, and position of prosthetic materials for mesh hiatoplasty. The indication for mesh implantation in the hiatal region should be carried out very carefully. More... »

PAGES

2298-2303

References to SciGraph publications

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  • Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1007/s00464-007-9514-3

    DOI

    http://dx.doi.org/10.1007/s00464-007-9514-3

    DIMENSIONS

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    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/17705084


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    33 schema:description BackgroundHiatal mesh implantation in the operative treatment of gastroesophageal reflux disease has become an increasing therapy option. Besides clinical results little is known about histological changes in the esophageal wall.MethodsTwo different meshes [polypropylene (PP), Prolene®; polypropylene–polyglecaprone 25 composite (PP–PG), Ultrapro®] were placed on the diaphragm circular the esophagus of 20 female rabbits. After three months a swallow with iodine water-soluble contrast medium for functional analysis was performed. After the animals were sacrificed, histopathological evaluation of the foreign-body reaction, the localization of the mesh relating to the esophageal wall was analyzed.ResultsSixteen rabbits survived the complete observation period of three months. After three months distinctive mesh shrinkage was observed in all animals and meshes had lost up to 50% of their original size before implantation. We found a delayed passage of the fluid into the stomach in all operated animals. There was a significant increased diameter of the outer ring of granulomas in the PP group (76.5 ± 8.0) compared to the PP–PG group (64 ± 8.5; p = 0.002). However, we found a mesh migration into the esophageal wall in six out of seven animals (PP) and five out of nine animals (PP-PG), respectively.ConclusionExperimental data suggest that more knowledge is necessary to assess the optimal size, structure, and position of prosthetic materials for mesh hiatoplasty. The indication for mesh implantation in the hiatal region should be carried out very carefully.
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    42 analysis
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    48 contrast medium
    49 data
    50 diameter
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    52 different meshes
    53 disease
    54 esophageal wall
    55 esophagus
    56 evaluation
    57 female rabbits
    58 fluid
    59 foreign body reaction
    60 functional analysis
    61 gastroesophageal reflux disease
    62 granulomas
    63 group
    64 hiatal region
    65 hiatoplasty
    66 histological changes
    67 histopathological evaluation
    68 implantation
    69 indications
    70 knowledge
    71 localization
    72 materials
    73 medium
    74 mesh
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    76 mesh implantation
    77 mesh migration
    78 mesh shrinkage
    79 migration
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    84 optimal size
    85 options
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    87 outer ring
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    92 rabbits
    93 reaction
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