Journal of Experimental and Clinical SurgeryJournal of Experimental and Clinical Surgery2070-478X2409-143XVoronezh State Medical University125810.18499/2070-478X-2019-12-3-172-175UnknownThe use of polypropylene mesh in thoracoplasty: an experimental and clinical studyBelovSergei А<p>candidate of medical science, thoracic surgeon of the 4th pulmonary surgical department</p>sur_belove@mail.ruhttps://orcid.org/0000-0001-5325-2891GrigoryukAlexander А<p>candidate of medical science, associate professor of the department of Surgery Institute</p>aa_grig@mail.ruhttps://orcid.org/0000-0002-7957-5872KrasnovDenis V<p>doctor of medicine, head of thoracic department</p>Krasnov77@bk.ruhttps://orcid.org/0000-0003-0727-9940Seaside regional antituberculous dispensary, VladivostokPacific State Medical UniversityNovosibirsk tuberculosis research institute2709201912317217514122018Copyright © 2019, Belov S.А., Grigoryuk A.А., Krasnov D.V.2019<p><strong><em>Relevance.</em></strong><em> Thoracoplasty is an effective way to close the cavity of destruction of the lung tissue and achieve clinical recovery in case of fibro-cavernous pulmonary tuberculosis. A promising direction of creating selective collapse in thoracoplasty is the use of synthetic mesh implants.</em></p>
<p><strong><em>The purpose of the study</em></strong><em> was to assess the effect of synthetic implants from the Surgipro" polypropylene mesh on the inflammatory and reparative reaction in thoracoplasty.</em></p>
<p><strong><em>Materials and methods.</em></strong><em> The work was performed on male Wistar rats weighing 25050 grams (n=12). The Surgipro polypropylene mesh was implanted on the right posterolateral surface of the chest (n=9). As control, the material was taken from intact rats (n=3), which were kept in the same conditions as experimental animals. The study material was biopsy specimens of the muscular aponeurotic scar of the posterolateral surface of the chest of rats. The cellular composition and total number of mast cells were determined. A clinical study was conducted on 26 cases of thoracoplastic with the use of polypropylene mesh in the pulmonary-surgical department of the Seaside regional antituberculous dispensary in Vladivostok.</em></p>
<p><strong><em>Results.</em></strong><em> During the experimental study, it was recorded that the implant used in the reconstruction of the chest has a pronounced reactogenicity from the first day, which manifests itself as a local inflammatory reaction with the concentration of mast cells. The population of mast cells progressively declined by the 30th day, while an increase in the number of macrophages and fibroblasts was observed with the advent of giant multinuclear cells of foreign bodies. On the 30th day after the operation, a widespread post-inflammatory reactive fibrosis and angiomatosis with chronic productive inflammation was observed in the experiment. In clinical observation, the resulting inflammatory reaction around the endoprosthesis spreads to the surrounding tissues and lung, which contributes to the formation of pronounced pulmonary fibrosis and restriction of a specific process.</em></p>tuberculosis, thoracoplasty, polypropylene meshтуберкулез, торакопластика, полипропиленовая сетка[Kuhtin O, Veith M, Alghanem M, Martel I, Giller D, Haas V, Lampl L. Thoracoplasty-Current View on Indication and Technique. Thorac Cardiovasc Surg. 2018.][Krasnov D, Krasnov V, Skvortsov D, Felker I. Thoracoplasty for Tuberculosis in the Twenty-first Century. Thoracic Surgery Clinics. 2017; 27: 2: 99-111.][Dewan RK, Moodley L. Resurgence of therapeutically destitute tuberculosis: amalgamation of old and newer techniques. J Thorac Dis. 2014; 6: 3: 196-201.][Belov SA. Thoracoplasty with polypropylene mesh in pulmonary tuberculosis treatment. Tuberkulez i bolezni legkikh. 2017; 95: 12: 6-9. (In Russ.)][Milyakova MN, Ponomareva YuV, Gribkova OV, Sarbaeva NN, Limareva LV, Bogush VV. Functional features of macrophages during the interaction with implants for hernioplasty. Sovremennye problemy nauki i obrazovaniya. 2016; 3: 189. (in Russ.)][Belov SA, Grigoryuk AA. Cytokines in surgery of pulmonary tuberculosis. Khirurgiya. Zhurnal im. N.I. Pirogova. 2018; 3(vol. 2): 39-42. (in Russ.)][Belov SA, Panchoyan VM. Patent 2634681 RF, MPK A61B17/00. Sposob khirurgicheskogo lecheniya tuberkuleza legkikh; zayavl.15.09.2016, opubl. 02.11.2017. Byul. №31. (in Russ.)][Belov SA, Panchoyan VM, Grigoryuk AA, Shapovalov AS, Bobyreva MG, Pimenov NA, Sudnischikov VV. Patent 2634625 RF, MPK A61B17/00. Sposob khirurgicheskogo lecheniya tuberkuleza legkikh; zayavl.15.09.2016, opubl. 02.11.2017. Byul. №31. (in Russ.)]