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

    https://app.dimensions.ai/details/publication/pub.1049226677

    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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    40 schema:keywords BackgroundHiatal mesh implantation
    41 ConclusionExperimental data
    42 MethodsTwo different meshes
    43 PP group
    44 PP–PG group
    45 ResultsSixteen rabbits
    46 alloplastic materials
    47 analysis
    48 animals
    49 changes
    50 clinical results
    51 comparison
    52 complete observation period
    53 contrast medium
    54 data
    55 diameter
    56 diaphragm
    57 different meshes
    58 disease
    59 distinctive mesh shrinkage
    60 esophageal wall
    61 esophagus
    62 evaluation
    63 female rabbits
    64 fluid
    65 foreign-body reaction
    66 functional analysis
    67 gastroesophageal reflux disease
    68 granulomas
    69 group
    70 hiatal region
    71 hiatoplasty
    72 histological changes
    73 histopathological evaluation
    74 implantation
    75 indications
    76 iodine water-soluble contrast medium
    77 knowledge
    78 localization
    79 materials
    80 medium
    81 mesh
    82 mesh hiatoplasty
    83 mesh implantation
    84 mesh migration
    85 mesh shrinkage
    86 migration
    87 months
    88 months distinctive mesh shrinkage
    89 more knowledge
    90 observation period
    91 operative treatment
    92 optimal size
    93 options
    94 original size
    95 outer ring
    96 passage
    97 period
    98 position
    99 prosthetic material
    100 rabbits
    101 reaction
    102 reflux disease
    103 region
    104 results
    105 ring
    106 shrinkage
    107 size
    108 stomach
    109 structure
    110 swallows
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