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Immunological reaction and oxidative stress after light or heavy polypropylene mesh implantation in inguinal hernioplasty

View Article: PubMed Central - PubMed

ABSTRACT

The relationship between mesh weight and host tissue reaction has, so far, not been fully investigated. Lightweight meshes (LWM) are thought to give less inflammatory response compared with heavyweight meshes (HWM). The present study is a randomized, controlled, double-blind clinical trial performed in 61 patients who underwent an elective inguinal hernioplasty. The primary outcome of the study was to investigate the relationship between total amount of prosthetic material (polypropylene), immunological reaction, and oxidative stress. The study was double-blinded. Sixty-one patients were recruited for the study and randomly assigned to 2 groups (groups A and B). Levels of inflammation markers (interleukin-6 [IL-6] and tumor necrosis factor-α [TNF-α]) and oxidative stress markers (reduced glutathione [GSH] and lipid hydroperoxides [LOOH]) were determined preoperatively and after undergoing inguinal hernioplasty (after 6, 72, and 288 hours), respectively, with LWM and HWM. There was no significant difference in IL-6 levels between HWM and LWM (P = 0.3, 0.7, 0.8 after 6, 72, and 288 hours, respectively). A statistically significant difference was found after 72 hours for TNF-α (P = 0.01), for GSH after 6 hours (P < 0.01), and after 6 and 72 hours for LOOH (P = 0.05, 0.01, respectively). Oxidative stress occurred at earlier time points and was pore accentuated HWM versus LWM and prodromal to TNF-α increase.

Also, in randomized clinical trial, the use of LWM gives advantages in terms of less inflammatory response when compared with HWM. Moreover, there is a significant higher oxidative stress after implantation of HWM. The intensity of oxidative stress seems to be strongly related to the amount of implanted polypropylene. (Trial registration number: NCT01090284).

No MeSH data available.


Overview of data, in blue lightweight mesh (LWM) mean values, and in red heavyweight meshes (HWM). Error bars represent standard error of the mean.
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Figure 1: Overview of data, in blue lightweight mesh (LWM) mean values, and in red heavyweight meshes (HWM). Error bars represent standard error of the mean.

Mentions: No statistical significance was found analyzing IL-6 levels, even if a trend of increase following amount of polypropylene could be found in postoperative time at 6 and 288 hours after mesh insertion (respectively preoperative, after 6, 72, and 288 hours: LWM 1.38, 8.92, 10.03, 7.99 pg/mL vs HWM 1.29, 11.87, 8.86, 8.4 pg/mL). This trend was also confirmed by TNF-α data even if gaining significance only after 72 hours (3.67 vs 14.3 pg/mL, P = 0.016) (Fig. 1).


Immunological reaction and oxidative stress after light or heavy polypropylene mesh implantation in inguinal hernioplasty
Overview of data, in blue lightweight mesh (LWM) mean values, and in red heavyweight meshes (HWM). Error bars represent standard error of the mean.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4998441&req=5

Figure 1: Overview of data, in blue lightweight mesh (LWM) mean values, and in red heavyweight meshes (HWM). Error bars represent standard error of the mean.
Mentions: No statistical significance was found analyzing IL-6 levels, even if a trend of increase following amount of polypropylene could be found in postoperative time at 6 and 288 hours after mesh insertion (respectively preoperative, after 6, 72, and 288 hours: LWM 1.38, 8.92, 10.03, 7.99 pg/mL vs HWM 1.29, 11.87, 8.86, 8.4 pg/mL). This trend was also confirmed by TNF-α data even if gaining significance only after 72 hours (3.67 vs 14.3 pg/mL, P = 0.016) (Fig. 1).

View Article: PubMed Central - PubMed

ABSTRACT

The relationship between mesh weight and host tissue reaction has, so far, not been fully investigated. Lightweight meshes (LWM) are thought to give less inflammatory response compared with heavyweight meshes (HWM). The present study is a randomized, controlled, double-blind clinical trial performed in 61 patients who underwent an elective inguinal hernioplasty. The primary outcome of the study was to investigate the relationship between total amount of prosthetic material (polypropylene), immunological reaction, and oxidative stress. The study was double-blinded. Sixty-one patients were recruited for the study and randomly assigned to 2 groups (groups A and B). Levels of inflammation markers (interleukin-6 [IL-6] and tumor necrosis factor-α [TNF-α]) and oxidative stress markers (reduced glutathione [GSH] and lipid hydroperoxides [LOOH]) were determined preoperatively and after undergoing inguinal hernioplasty (after 6, 72, and 288 hours), respectively, with LWM and HWM. There was no significant difference in IL-6 levels between HWM and LWM (P = 0.3, 0.7, 0.8 after 6, 72, and 288 hours, respectively). A statistically significant difference was found after 72 hours for TNF-α (P = 0.01), for GSH after 6 hours (P < 0.01), and after 6 and 72 hours for LOOH (P = 0.05, 0.01, respectively). Oxidative stress occurred at earlier time points and was pore accentuated HWM versus LWM and prodromal to TNF-α increase.

Also, in randomized clinical trial, the use of LWM gives advantages in terms of less inflammatory response when compared with HWM. Moreover, there is a significant higher oxidative stress after implantation of HWM. The intensity of oxidative stress seems to be strongly related to the amount of implanted polypropylene. (Trial registration number: NCT01090284).

No MeSH data available.