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Open Access 01-12-2008 | Research article

Different tissue reaction of oesophagus and diaphragm after mesh hiatoplasty. Results of an animal study

Authors: Jens Otto, Daniel Kämmer, Petra Lynen Jansen, Michael Anurov, Svetlana Titkova, Alexander Öttinger, Raphael Rosch, Volker Schumpelick, Marc Jansen

Published in: BMC Surgery | Issue 1/2008

Abstract

Background

Laparoscopic mesh-reinforcement of the hiatal region in the treatment of gastroesophageal reflux disease (GERD) and paraesophageal hernia (PEH) reduces the risk of recurrence. However, there are still controversies about the technique of mesh placement, shape, structure and material. We therefore compared tissue integration and scar formation after implantation of two different polypropylene-meshes in a rabbit model.

Methods

A total of 20 female chinchilla rabbits were included in this study. Two different meshes (Polypropylene PP, Polyglecaprone 25 Composite PP-PG) were implanted on the abdominal diaphragm around the oesophagus. After 3 months the implanted meshes were excised en-bloc. Histological and morphological analyses were carried out accordingly proliferation rate, apoptosis and collagen type I/III ratio.

Results

Regarding proliferation rate of oesophagus PP (9.31 ± 3.4%) and PP-PG (13.26 ± 2.54%) differ in a significant (p = 0.0097) way. In the diaphragm we found a significant (p = 0.00066) difference between PP (9.43 ± 1.45%) and PP-PG (18.73 ± 5.92%) respectively. Comparing oesophagus and diaphragm we could prove a significant difference within PP-PG-group (p = 0.0195). Within PP-group the difference reached no statistical significance (p = 0.88). We found analogous results regarding apoptosis.

Furthermore, there is a significant (p = 0.00013) difference of collagen type I/III ratio in PP-PG (12.28 ± 0.8) compared to PP (8.44 ± 1,63) in case of oesophageal tissue. Concerning diaphragm we found a significant difference (p = 0.000099) between PP-PG (8.85 ± 0.81) and PP (6.32 ± 1.07) as well.

Conclusion

The histologic and morphologic characteristics after prosthetic enforcement of the hiatus in this animal model show a more distinct tissue integration using PP-PG compared to PP. Additionally, different wound healing and remodelling capability influence tissue integration of the mesh in diaphragm and oesophagus.

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The pre-publication history for this paper can be accessed here:http://www.biomedcentral.com/1471-2482/8/7/prepub

Title: Different tissue reaction of oesophagus and diaphragm after mesh hiatoplasty. Results of an animal study
Authors: Jens Otto
Daniel Kämmer
Petra Lynen Jansen
Michael Anurov
Svetlana Titkova
Alexander Öttinger
Raphael Rosch
Volker Schumpelick
Marc Jansen
Publication date: 01-12-2008
Publisher: BioMed Central
Published in: BMC Surgery / Issue 1/2008
Electronic ISSN: 1471-2482
DOI: https://doi.org/10.1186/1471-2482-8-7

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Different tissue reaction of oesophagus and diaphragm after mesh hiatoplasty. Results of an animal study

Abstract

Background

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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