Identifier: TDX:646
Authors: Marsal Cavallé, Francesc
Abstract:
Straps of (2 x 0.5 cm) of polypropylene (PP), PTFE and 910-polyglactin (910-P), were inserted subcutaneously over the anterior abdominal wall on 15 Wistar rats (200-250g). Animals were sacrificed at one; four and 12 weeks after operation, and samples of abdominal wall + mesh were obtained for histological and mechanical study. All meshes developed minimal inflammation. One week after surgery, the smallest amount of granulation tissue was observed around PP. 910-P disappeared around the fourth week and developed a greater fibrosis than PP and PTFE. Samples of abdominal wall + mesh obtained four weeks after operation were tested for tensile strength. In all cases, tensile strength was greater in these samples than in the undisturbed abdominal wall of the rat (control = 1.2+/- 0.5 kg/cm). However, tensile strength with PP (8.9 +/- 0.65) and PTFE (9.4 +/- 1.3) was greater than with 910-P (1.7+/- 0.74).One hundred-thirty-nine patients (age 17-85) were selected by the same surgeon for ambulatory treatment of unilateral (118) or bilateral (21) inguinal hernia. The latter group were treated in one (4) or two (17) operations, with a total of 156 cases. All cases were operated on under local anaesthesia by the technique of tension-free-hernioplasty, by placement of a polypropylene mesh. In 141 cases (90%), the patient was discharged home on the same day of operation. There was no operative mortality and only one case of recurrence in this series (follow up = 2-24 months; 90% of patients). There were 20 postoperative complications (14.3%), with no intolerance of the prosthetic mesh. Patients were requested to fill in questionnaires to asses the degree of pain and anxiety experienced before, during and after the operation. Pain anxiety was minimal in more than 90% cases, local anaesthesia showing better tolerance among older patients.
Repositori URV