Berna ERSöz KANAY, Serpil DAĞ, Mustafa GöK, Engin KILIÇ, Sadık YAYLA, Celal Şahin ERMUTLU, Vedat BARAN, Kemal KILIÇ

Ventral Hernilerin Onarımında Polyester Film Kullanımının Erken ve İleri Dönem Sonuçlarının Değerlendirilmesi: Tavşan Modellerinde Deneysel Bir Çalışma

Bu çalışmada, tavşanlarda deneysel olarak oluşturulan ventral herni modelinde, polyester film kullanımının erken ve ileri dönem klinik, MR, USG ve histopatolojik sonuçlarının değerlendirilmesi amaçlanmıştır. Çalışmada kullanılan 16 adet Yeni Zellanda tavşanı 8’erli 2 gruba ayrıldı. Operasyonlar xylazin HCl sedasyonunu izleyerek ketamin HCl ile elde edilen genel anestezi altında gerçekleştirildi. Operasyon masasına sırtüstü pozisyonda yatırılan tavşanlara median deri ensizyonu yapıldıktan sonra linea alba düzeyinde 2 cm çaplı daire şeklinde bir defekt oluşturuldu. Defekt önceden disk şeklinde hazırlanan 4 cm çaplı daire şeklindeki polyester film ile onarıldı. I. Gruptaki tavşanların 15, II. gruptakilerin ise 60 günlük klinik takibin sonunda USG ve MR görüntüleri alındıktan sonra bu tavşanlara relaparotomi uygulanarak peritoneal adezyon varlığı görsel olarak değerlendirildi. Çalışmadan elde edilen tüm veriler Minitab-16 paket programı kullanılarak istatistiksel olarak değerlendirildi. Greft uygulanan bölgeye ait doku örnekleri Hematoksilen-Eozin (HE) ve Crossman’ın üçlü boyama yöntemi ile boyanarak ışık mikroskobunda değerlendirildi. Histopatolojik incelemede 15 günlük gruptaki hayvanların tamamında uygulama yapılan alanda fibröz doku ile onarım gözlendi. Ayrıca her iki grupta da yabancı cisim dev hücre reaksiyonu ve nekroz oluşumu gözlenmedi. Klinik, USG ve MR bulguları ile relaparotomik makroskopik ve histopatolojik sonuçlar polyester filmin tavşanlarda ventral herni sağaltımında başarılı sonuçlar verdiğini ortaya koymuştur. Sonuç olarak çalışmadan elde edilen veriler dikkate alındığında bu materyalin evcil hayvanlarda görülen geniş defektli fıtıkların onarımında kullanılabilceği sonucuna varıldı.

Evaluation of Early and Late Period Results of Polyester Film Use for the Repair of Ventral Hernias: An Experimental Study on Rabbit Models

The purpose of this study is to assess clinical, MR, USG and histopathological findings of early and later results of polyester film use in experimental ventral hernia model in rabbits. In this study, 16 New Zealand rabbits were divided into 2 groups of 8 rabbits each. After xylazine HCl usage as a sedative, the surgery is conducted under general anaesthesia by ketamine HCl. Upon median skin incision, a 2 cm diameter round defect on linea alba level was formed in rabbits lying in the supine position. The defect was repaired with 4 cm diameter polyester film which had been prepared beforehand in the shape of a disc. After clinical follow up of 15 days for rabbits in group I and 60 days for group II, USG and MR images were taken, by re-laparotomy the presence and extent of peritoneal adhesion was examined visually. All data from the study were statistically assessed via Minitab-16 package program. Tissue samples from the graft area were stained through hematoxylineozin and Crossman’s triple dye and assessed by usage of light microscope. During histopathological examination, it was observed repair by fibrous tissue in the area where surgery was performed for all the animals in 15 day group. Neither foreign body giant cell reaction nor necrosis was observed in two groups. When clinical, USG, MR findings along with re-laparotomy, macroscopic and histopathological results are taken into account, it was seen that polyester film bore successful results with regards to ventral hernia therapy in rabbits. Based on the data provided by this study, it is decided that the mentioned material should be tried for large hernia defect repair in domestic animals.

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