Effect Of Anterior Peritoneal Gap Patch Repair On Muscle In Rats With Incisional Hernia

Objective To explore the pathological changes of abdominal wall muscles after incisional hernia preperitoneal space mesh repair and the expression of VEGF and Ang-1 in serum after surgery.Methods The 80 SD rats were randomly divided into control group(n=8),incisional hernia model group(n=8),hernia-free implantation mesh group(1 week postoperative group(n=8),4 weeks postoperative group(n=8),8 weeks postoperative group(n=8),12 weeks postoperative group(n=8)),hernia mesh repair group(1 week postoperative group(n=8),4 weeks postoperative group(n=8),8 weeks postoperative group(n=8),12 weeks postoperative group(n=8)),the control group did not do any treatment,and the rat abdominal wall muscle samples and blood samples were taken.The incision hernia model group carried out incision hernia mold,abdominal wall muscle specimens and blood samples were taken after 2 weeks,the mesh group without hernia was implanted to separate the muscles,and the polypropylene mesh was implanted in the anterior peritoneal space,while the hernia mesh repair group first performed incision hernia mold,and after successful molding,the polypropylene mesh was implanted into the anterior peritoneal space,and the mesh was inserted into the abdominal wall muscle specimens and blood samples 1,4,8 and 12 weeks after surgery,the inflammatory cell infiltration and fibrous tissue hyperplasia of the abdominal wall muscle were observed,and the expression of VEGF and Ang-1 in serum was measured.Results(1)Degree of inflammatory cell infiltration: Compared with the control group,the degree of inflammatory cell infiltration was increased in the incision hernia model group and the hernia implantation mesh group.Compared with the incision hernia model group,the degree of inflammatory cell infiltration was significantly increased in the hernia mesh repair group at 1 week postoperative group,while there was no significant difference in the degree of inflammatory cell infiltration in the hernia mesh repair group at 4,8 and 12 weeks after surgery compared with the incision hernia model group.Compared with the hernia mesh repair group,there was no significant difference in the degree of inflammatory cell infiltration at 4,8 and 12 weeks after surgery,but compared with the group with hernia mesh repair 1 week after repair,the degree of inflammatory cell infiltration was significantly reduced.Compared with the two groups in the hernia implantation mesh group,the degree of inflammatory cell infiltration in the 1-week group was higher than that in the 4,8 and 12-week groups,and the degree of inflammatory cell infiltration in the 4-week group was higher than that in the 12-week postoperative group,while there was no significant difference in the degree of inflammatory cell infiltration in the 8-week group compared with the 12-week group.Compared with the time period of the hernia implantation mesh group and the hernia mesh repair group,there was no significant difference in the degree of inflammatory cell infiltration.(2)Degree of fibrous tissue hyperplasia: Compared with the control group,the degree of fibrous tissue hyperplasia was increased in the incision hernia model group and the hernia-free mesh implantation group.Compared with the incision hernia model group,the degree of fibrous tissue hyperplasia was increased in the hernia mesh repair group at 1 and 4 weeks after surgery,while there was no significant difference in the degree of fibrous tissue hyperplasia in the hernia mesh repair group 8 and 12 weeks after surgery compared with the incision hernia model group.The hernia mesh repair group was compared with two pairs,and the group 8 and 12 weeks after surgery was lighter than that in the 1 and 4 weeks after surgery.Compared with the two groups in the hernia implantation mesh group,the degree of fibrous tissue hyperplasia in the group 1 week after surgery was higher than that in the 8 and 12 weeks after surgery,while there was no significant difference in the degree of fibrous tissue hyperplasia in the 4,8 and 12 weeks after surgery.Compared with the hernia mesh group and the hernia mesh repair group,there was no significant difference in the degree of fibrous tissue hyperplasia.(3)Expression of VEGF and Ang-1 in serum: Compared with the control group,the concentration of Ang-1 in serum increased in the incision hernia model group,and there was no significant difference in VEGF concentration.There were no significant differences between VEGF and Ang-1 concentrations in the hernia mesh repair group at1,4,8 and 12 weeks after surgery compared with the incision hernia model group.Compared with the control group,there were no significant differences in VEGF and Ang-1 concentrations in the hernia implant-free mesh group at 1,4,8 and 12 weeks after surgery compared with the control group.Compared with the hernia mesh repair group and the non-hernia implantation mesh group,the level of Ang-1 decreased in the group 12 weeks after the operation in the non-hernia mesh repair group than in the hernia mesh repair group at 12 weeks after surgery,and there were no significant differences in VEGF and Ang-1 concentrations in the remaining time periods.Conclusion(1)Trauma and the presence of a mesh foreign body may cause pathological changes in abdominal wall muscle inflammation cell infiltration and fibrous tissue hyperplasia,which are most severe at 1 week postoperatively,subside thereafter,and persist for several months,and may be related to the clinical pain during movement of the mesh insertion area after preperitoneal space mesh repair.(2)The presence of trauma may cause an increase in Ang-1 without causing significant changes in VEGF,and the presence of hernia and mesh foreign bodies has little effect on the concentration of VEGF and Ang-1 in serum.