The Possible Ways of Adhesions Prophylaxis in Prosthetic Repair of Abdominal Wall (Experimental Study)

Abstract


Relevance The treatment of patients with incisional hernias of abdominal wall is an actual question of surgery. The introduction of prosthetic repair improved outcomes of incisional hernia treatment and provided good life quality of operated patients. The unsolved problem is the prevention and treatment of complications associated with adhesions in the area of implantation of synthetic prosthesis. Are important works in which were studied the possibility of antiadhesive compositions based on hyaluronic acid.
The purpose of the study Is the study of possibilities of pharmacological compositions based on hyaluronic acid as a means of adhesions prevention in intraperitoneal prosthetic repair of abdominal wall.
Materials and methods In rabbits were implanted polypropylene (PP Std), light polypropylene (PP Light), polyvinylidenfluoride (PVDF) meshes by open IPOM technique. In basic group was used the composition based on hyaluronic acid. In control group the animals were operated without antiadhesive means. The implantation area was analyzed in 30 days.
Results and thier discussion In the control group, each of the implanted material developed an adhesive process. In some cases were observed strong adhesions. Ability endoprosthesis lead to the adhesions formation in the abdominal cavity was maximal in PP Std, medium in PP Light and minimum in PVDF series (non-significant). In the basic group adhesions were significantly low compared to the control. The observed differences were significant when comparing the groups and by comparing the results of implantation of each material separately. The most significant difference between the groups was observed in PP Std series. The most favorable results were noted in PVDF series of basic group.
Conclusion The antiadhesive impact of composition based on hyaluronic acid is confirmed in our experimental study. This effect dependent on the material of mesh. The morphological features of reparative process after prosthetic repair with use of composition based on hyaluronic acid should be studied.

Nizhnii Novgorod State Medical Academy, 10/1 Minina i Pozharskogo Sqr., Nizhnii Novgorod, 603005, Russian Federation

Author for correspondence.
Email: admin@vestnik-surgery.com
MD, Prof., B.А. Korolyov Department of Hospital Surgery, Nizhnii Novgorod State Medical Academy

Nizhnii Novgorod State Medical Academy, 10/1 Minina i Pozharskogo Sqr., Nizhnii Novgorod, 603005, Russian Federation

Email: admin@vestnik-surgery.com
PhD, Surgeon, Nizhni Novgorod City Hospital No.35

Nizhnii Novgorod State Medical Academy, 10/1 Minina i Pozharskogo Sqr., Nizhnii Novgorod, 603005, Russian Federation

Email: admin@vestnik-surgery.com
Surgeon, Nizhnii Novgorod City Hospital No.35

Central Scientific Research Laboratory of Scientific Research Institute Applied and Fundamental Medicine, 70 Gagarin Ave., Nizhnii Novgorod, 603059, Russian Federation

Email: admin@vestnik-surgery.com
PhD, Assistant Prof., the Department of Humans and Animals Physiology and Biochemistry, the Nizhny Novgorod State University named after N.I.Lobachevsky, Research Worker, the Department of Neurophysiology and Experimental Simulation, Central Scientific Research Laboratory of Scientific Research Institute of Applied and Fundamental Medicine, Nizhnii Novgorod State Medical Academy

Nizhnii Novgorod State Medical Academy, 10/1 Minina i Pozharskogo Sqr., Nizhnii Novgorod, 603005, Russian Federation

Email: admin@vestnik-surgery.com
Urologist, Scientific Research Institute of Physical – Chemical Medicine, Federal Medical and Biological Agency, Moscow

  1. Egiev V.N., Liadov V.K., Bogomazova S.Iu. Sravnitel'naya ocenka materialov dlya vnutribryushinnoj plastiki gryzh: ehksperimental'noe issledovanie. [Comparative evaluation of materials for intraperitoneal plastic hernias: an experimental study]. Khirurgiia, 2010; 10: 36-41. - (in Russ.).
  2. Kulikov L.K., Buslaev O.A., Shalashov S.V., Smirnov A.A., Mikhailov A.L., Egorov I.A., Shadarov L.P., Sobolev S.T., Sobotovich V.F., Privalov Iu.A. Hirurgicheskoe lechenie bol'shih i gigantskih posleoperacionnyh ventral'nyh gryzh. [Surgical treatment of large and giant postoperative ventral hernias]. Novosti khirurgii, 2013; 2: 37-44. - (in Russ.).
  3. Mishalov V.G., Byk P.L., Leshchishin I.M., Golinko V.N., Okhotskaia O.I. Ispol'zovanie anti-klej gelya v rezekcii uchastka kishki na fone spaek odnovremenno s plastikoj bryushnoj stenki prolenovoj setkoj v ehksperimente. [The use of anti adhesive gel at the site resection of the intestine against the backdrop adhesions simultaneously with the plastic abdominal wall prolene mesh in the experiment]. Khirurgiia Ukrainy, 2014; 1(49): 43-53. - (in Russ.).
  4. Osadchii D.M. Izuchenie dinamiki gialuronovoj kisloty i gidroksiprolina, kak markera metabolizma soedinitel'noj tkani. [The study of dynamics hyaluronic acid and related hydroxyproline as a marker for connective tissue metabolism.] Aktual'nye problemy transportnoi meditsiny, 2013; 2(32): 131-133. - (in Russ.).
  5. Pleshkov V.G., Agafonov O.I. Posleoperacionnaya ventral'naya gryzha - nereshennye problemy. [Postoperative ventral hernia - unsolved problems.] Vestnik eksperimental'noi i klinicheskoi khirurgii, 2009; 3: 248-255. - (in Russ.).
  6. Sukovatykh B.S., Bezhin A.I., Lipatov V.A., Lazarenko V.A., Dubonos A.A., Zhukovskii V.A. Klinicheskaya ehffektivnost' vnutribryushnoj implantacii s pomoshch'yu "Mezogel". [Clinical efficacy of intraperitoneal implantation means "Mezogel".] Vestnik novykh meditsinskikh tekhnologii, 2010; 3(17): 16-18. - (in Russ.).
  7. Tashkinov N.V., Kulikova N.A., Kogut B.M., Bel'mach V.P., Panenkov A.N. Vyyavlenie pacientov s ochen' vysokim riskom posleoperacionnyh ventral'nyh gryzh vo vremya sredinnoj laparotomii. [Identification of patients with a very high risk of postoperative ventral hernias during median laparotomy]. Dal'nevostochnyi meditsinskii zhurnal, 2013; 4: 31-33. - (in Russ.).
  8. Timerbulatov M.V., Timerbulatov Sh.V., Gataullina E.Z., Valitova E.R. Posleoperacionnye ventral'nye gryzhi: sovremennoe sostoyanie. [Postoperative ventral hernia: state of the art.] Meditsinskii vestnik Bashkortostana, 2013;5: 101-107. - (in Russ.).
  9. Khasanov A.G., Kunafin M.S., Ponedel'kina I.Iu., Timerbulatov V.M., Faiazov R.R., Sufiiarov I.F. Sposob profilaktiki razvitiia posleoperatsionnykh spaek briushnoi polosti [A method for preventing development of postoperative abdominal adhesions]. Patent RF №2233164. 2003: 08.01. - (in Russ.).
  10. Shmatov K.V. Gialuronovaya kislota - katalizator regeneracii. [Hyaluronic acid - catalyst regeneration.] Meditsinskii alfavit, 2011; 17(4): 32-35. - (in Russ.).
  11. Altinli E., Sumer A., Koksal N., Onur E., Senger S., Eroglu E., Celik A., Gumrukcu G. Prevention of adhesion to prosthetic mesh: comparison of oxidized generated cellulose, polyethylene glycol and hylan G-F 20. Ulus Travma Acil. Cerrahi. Derg., 2011; 17(5): 377-82.
  12. Alkhamesi N.A., Schlachta C.M. The role of aerosolized intraperitoneal heparin and hyaluronic acid in the prevention of postoperative abdominal adhesions. Surg. Endosc., 2013; 27(12): 4663-9.
  13. Berger D., Lux A. Operative therapy of secondary ventral hernia: technical principles. Chirurg., 2013 ; 84(11): 1001-12.
  14. Caglayan K., Gungor B., Cinar H., Erdogan N.Y., Koca B. Preventing intraperitoneal adhesions with linezolid and hyaluronic acid/carboxymethylcellulose: a comparative study in cecal abrasion model. Am. J. Surg., 2014; 208(1): 106-11.
  15. Diamond M.P., Burns E.L., Accomando B., Mian S., Holmdahl L. Seprafilm® adhesion barrier: a review of preclinical, animal, and human investigational studies. Gynecol. Surg., 2012 September; 9(3): 237–245.
  16. Hanna E.M., Byrd J.F., Moskowitz M., Mann J.W.F., Stockamp K.T., Patel G.N., Beneke M.A., Millikan K., Iannitti D.A. Outcomes of a prospective multi-center trial of a second generation composite mesh for open ventral hernia repair. Hernia, 2014; 18: 81–89.
  17. Mayagoitia-Gonzalez J.C., Gudino-Amezcua L.M., Rivera-Barragan V., Mellado-Diaz A.V., Diaz-Chavez E.P. Prevention of intestinal adhesions as a result of intraperitoneal mesh with the addition of hyaluronic acid/carboxymethylcellulose gel. Experimental model in rats. Cir. Cir., 2012; 80(2): 150-6.
  18. Nohuz E., Alaboud M., Darcha C., Alloui A., Aublet-Cuvelier B., Jacquetin B. Effectiveness of Hyalobarrier and Seprafilm to prevent polypropylene mesh shrinkage: a macroscopic and histological experimental study. Int. Urogynecol. J., 2014; 25(8): 1081-7.
  19. Ruggiero R., Gubitosi A., Docimo G., Gili S., Tolone S., Bosco A., Casalino G., Docimo L. Hyaluronic acid and adhesions on polypropylene endoperitoneal mesh: an experimental study. Ann. Ital. Chir., 2013; 84(1): 87-92.
  20. Sahoo M.R., Bisoi S., Mathapati S. Polypropelene mesh eroding transverse colon following laparoscopic ventral hernia repair. J. Minim. Access Surg., 2013; 9(1): 40-41.

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