Morphological changes in anterior abdominal wall and large intestine tissues while modeling paracolostomic hernia in various times after operation

Abstract

Background. Currently, an increase in the number of operations for colorectal cancer, developmental anomalies, and large intestine trauma resulting in the removal of a colostomy is noted in the world. The use of a xenopericardial plate as an endoprosthesis for paracolostomy hernias seems to be relevant. The purpose of the research is to study the features of reparative processes, as well as the results of the integration of the xenopericardium during its implantation into the aponeurosis of the external oblique muscle of the abdomen in the area of the hernial orifice and the intestinal wall, removed as a colostomy. Materials and methods. In an experiment on rabbits of the chinchilla breed, the removal of a colostomy was simulated, followed by intra-abdominal implantation of a previously prepared hernioprosthesis from a xenopericardium and a polypropylene mesh. Results. A comparative analysis of the features of the connective tissue’s growth in the zones of implantation was carried out by counting the number of fibroblasts and fibrocytes. Differences in the development of inflammation and neovascularization in the areas of integration of xenopericardium and mesh endoprosthesis were assessed. Conclusions. The inflammatory reaction upon implantation into the zone of the aponeurosis and the intestinal wall of both the xenopericardial plate and the mesh regresses by the end of the month after the operation. However, the contact of the synthetic material with the intestinal wall leads to pronounced necrotic changes extending up to the submucosal layer, which was not observed after implantation of the biological material. Thus, in those cases of plastic surgery, when the contact of the implant with the intestinal wall is possible, the use of biological materials is preferable.

Keywords

• paracolostomy hernia
• xenopericardium
• mesh endoprosthesis
• colostomy