Hernioplastia sin tensión para el tratamiento ambulatorio de la hernia inguinal.estudio clinico propes.
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 histol...
| Autor: | |
|---|---|
| Tipo de recurso: | tesis doctoral |
| Estado: | Versión publicada |
| Fecha de publicación: | 1992 |
| País: | España |
| Institución: | Universitat Rovira i virgili (URV) |
| Repositorio: | Repositori Institucional de la Universitat Rovira i Virgili |
| OAI Identifier: | oai:urv.cat:TDX:646 |
| Acceso en línea: | https://hdl.handle.net/20.500.11797/TDX646 http://hdl.handle.net/10803/8868 |
| Access Level: | acceso abierto |
| Palabra clave: | 617 - Cirurgia. Ortopèdia. Oftalmologia 61 - Medicina |
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oai:urv.cat:TDX:646 |
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España |
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| dc.title.none.fl_str_mv |
Hernioplastia sin tensión para el tratamiento ambulatorio de la hernia inguinal.estudio clinico propes. |
| title |
Hernioplastia sin tensión para el tratamiento ambulatorio de la hernia inguinal.estudio clinico propes. |
| spellingShingle |
Hernioplastia sin tensión para el tratamiento ambulatorio de la hernia inguinal.estudio clinico propes. Marsal Cavallé, Francesc 617 - Cirurgia. Ortopèdia. Oftalmologia 61 - Medicina |
| title_short |
Hernioplastia sin tensión para el tratamiento ambulatorio de la hernia inguinal.estudio clinico propes. |
| title_full |
Hernioplastia sin tensión para el tratamiento ambulatorio de la hernia inguinal.estudio clinico propes. |
| title_fullStr |
Hernioplastia sin tensión para el tratamiento ambulatorio de la hernia inguinal.estudio clinico propes. |
| title_full_unstemmed |
Hernioplastia sin tensión para el tratamiento ambulatorio de la hernia inguinal.estudio clinico propes. |
| title_sort |
Hernioplastia sin tensión para el tratamiento ambulatorio de la hernia inguinal.estudio clinico propes. |
| dc.creator.none.fl_str_mv |
Marsal Cavallé, Francesc |
| author |
Marsal Cavallé, Francesc |
| author_facet |
Marsal Cavallé, Francesc |
| author_role |
author |
| dc.contributor.none.fl_str_mv |
Departament de Medicina i Cirurgia Universitat Rovira i Virgili. |
| dc.subject.none.fl_str_mv |
617 - Cirurgia. Ortopèdia. Oftalmologia 61 - Medicina |
| topic |
617 - Cirurgia. Ortopèdia. Oftalmologia 61 - Medicina |
| description |
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 anae |
| publishDate |
1992 |
| dc.date.none.fl_str_mv |
1992 |
| dc.type.none.fl_str_mv |
info:eu-repo/semantics/publishedVersion info:eu-repo/semantics/doctoralThesis |
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doctoralThesis |
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publishedVersion |
| dc.identifier.none.fl_str_mv |
https://hdl.handle.net/20.500.11797/TDX646 http://hdl.handle.net/10803/8868 |
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https://hdl.handle.net/20.500.11797/TDX646 http://hdl.handle.net/10803/8868 |
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Español |
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Español |
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info:eu-repo/semantics/openAccess |
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openAccess |
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application/pdf |
| dc.publisher.none.fl_str_mv |
Universitat Rovira i Virgili |
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Universitat Rovira i Virgili |
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urn:isbn:9788469245255 reponame:Repositori Institucional de la Universitat Rovira i Virgili instname:Universitat Rovira i virgili (URV) |
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Universitat Rovira i virgili (URV) |
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Repositori Institucional de la Universitat Rovira i Virgili |
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Repositori Institucional de la Universitat Rovira i Virgili |
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| _version_ |
1869415845581553664 |
| spelling |
Hernioplastia sin tensión para el tratamiento ambulatorio de la hernia inguinal.estudio clinico propes.Marsal Cavallé, Francesc617 - Cirurgia. Ortopèdia. Oftalmologia61 - MedicinaStraps 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 anaeDesde hace más de 100 años, la prevalencia de hernia inguinal recidivada (10-20% de todas las hernias operadas), no se ha modificado. Recientemente, se ha introducido el concepto de 'Hernioplastia sin Tensión' (HST) para la reparación de la hernia inguinal, mediante la implantación de una malla de material sintético cubriendo los defectos sobre la fascia transversalis, sin otras modificaciones anatómicas, obteniéndose un índice de recidiva prácticamente nulo. Con el propósito de comparar las propiedades de los biomateriales de uso clínico mas frecuente, implantamos subcutáneamente sobre la pared abdominal anterior de la rata Wistar (200-250g), retales de malla de polipropileno ( Prolene®-PP), politetrafluoroetileno expandido ( Gore-Tex®-PTFE) y poliglactin 910 ( Vicryl®-P910). Siguiendo la normativa de la ' American Society for Testing and Materials', (ASTM), los animales fueron repartidos en tres grupos y sacrificados a la semana, 4 semanas y 12 semanas, obteniendo las muestras del conjunto pared muscular + malla. Cada muestra fue dividida en dos partes, una para estudio histológico y otra para estudio biomecánico.Los resultados fueron evaluados por un observador neutral mediante una escala semicuantitativa de grados. Los tres tipos de malla desencadenaron una reacción inflamatoria mínima, sobre los tejidos de experimentación. La fibrosis desencadenada, fue progresiva en las tres mallas y en todo momento más marcada en el P910.Las muestras del conjunto malla+ pared muscular obtenidas a las 4 semanas, fueron traccionadas con un dinamómetro de precisión Instron®, a velocidad constante, generando curvas de fuerza tensil - tiempo, hasta el momento de la ruptura. En todos los casos la resistencia a la ruptura fue mayor en las muestras ensayadas que en la pared musculoaponeUniversitat Rovira i Virgili Departament de Medicina i CirurgiaUniversitat Rovira i Virgili.1992info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/doctoralThesisapplication/pdfhttps://hdl.handle.net/20.500.11797/TDX646http://hdl.handle.net/10803/8868urn:isbn:9788469245255reponame:Repositori Institucional de la Universitat Rovira i Virgiliinstname:Universitat Rovira i virgili (URV)Españolinfo:eu-repo/semantics/openAccessADVERTIMENT. L'accés als continguts d'aquesta tesi doctoral i la seva utilització ha de respectar els drets de la persona autora. Pot ser utilitzada per a consulta o estudi personal, així com en activitats o materials d'investigació i docència en els termes establerts a l'art. 32 del Text Refós de la Llei de Propietat Intel·lectual (RDL 1/1996). Per altres utilitzacions es requereix l'autorització prèvia i expressa de la persona autora. En qualsevol cas, en la utilització dels seus continguts caldrà indicar de forma clara el nom i cognoms de la persona autora i el títol de la tesi doctoral. No s'autoritza la seva reproducció o altres formes d'explotació efectuades amb finalitats de lucre ni la seva comunicació pública des d'un lloc aliè al repositori institucional de la Universitat Rovira i Virgili. Tampoc s'autoritza la presentació del seu contingut en una finestra o marc aliè a aquest repositori (framing). Aquesta reserva de drets afecta tant als continguts de la tesi com als seus resums i índexs.oai:urv.cat:TDX:6462026-06-23T12:42:27Z |
| score |
15,300719 |