Acute inflammatory response after inguinal and incisional hernia repair with implantation of polypropylene mesh of different size
Acute inflammatory response after inguinal and incisional hernia repair with implantation of polypropylene mesh of different size
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DOI：
10.1007/s00423-004-0534-3
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发表时间：
2005-08-01
影响因子：
2.3
通讯作者：
Cillari, E
中科院分区：
文献类型：
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作者：
Di Vita, G;D'Agostino, P;Cillari, E
背景资料：本研究的目的是评估植入聚丙烯补片后白细胞介素（IL）-6、C反应蛋白（CRP）、白细胞和纤维蛋白原的变化。方法：将36例患者随机分为两组。第一组分配了腹股沟疝患者，接受传统修补术（亚组Ia）或40 cm（2）聚丙烯补片疝修补术（亚组Ib）。第二组分配了切口疝患者，接受传统修补术（亚组IIa）或使用400 cm（2）聚丙烯补片进行切口疝修补术（亚组IIb）。分别于术前24 h、术后6 h、24 h、48 h和168 h采集外周静脉血。结果如下：我们提出的证据表明，血清中的IL-6，CRP，白细胞和纤维蛋白原水平显着增加，术后与他们的基线值相比，在所有亚组。特别是，炎症介质的产生在Ib亚组比Ia亚组和IIb亚组比IIa亚组更高。比较各组间炎症反应的实体，我们发现，很明显，它们在Ib和IIa亚组中相似，并且在IIb亚组中最高，在Ia亚组中最低。结论：数据显示，传统腹股沟疝和切口疝修补术诱导的炎症反应小于使用聚丙烯补片进行两种手术时观察到的炎症反应。此外，结果表明，更大的补片与更高的炎症介质产生相关。
Background: The purpose of this study was to assess the modifications of interleukin (IL)-6, C-reactive protein (CRP), leukocytes and fibrinogen after implantation of polypropylene mesh. Methods: Thirty-six patients were included in this study and divided into two groups. To the first group were allocated patients affected by inguinal hernia and undergoing conventional repair (subgroup Ia) or hernioplasty with 40-cm(2) polypropylene mesh (subgroup Ib). To the second group were allocated patients affected by incisional hernia and undergoing conventional repair (subgroup IIa) or incisional hernia repair with 400-cm(2) polypropylene mesh (subgroup IIb). Peripheral venous blood samples were collected 24 h before surgery and then 6, 24, 48 and 168 h postoperatively. Results: We present evidence that serum levels of IL-6, CRP, leukocytes and fibrinogen were significantly increased postoperatively in all subgroups compared with their baseline values. In particular, the production of inflammatory mediators was higher in subgroups Ib vs Ia and IIb vs IIa. Comparing the entities of the inflammatory responses among various groups we found that it was clear that they were similar in subgroups Ib and IIa, and that the highest were in subgroup IIb and the lowest in subgroup Ia. Conclusion: The data show that conventional inguinal and incisional hernia repair induces an inflammatory response, which is smaller than that observed if both operations are carried out with polypropylene meshes. Furthermore, the results suggest that a larger mesh is associated with a higher production of inflammation mediators.