小鼠腹壁不同解剖层次丝线线结周围异物巨细胞浸润和纤维化程度的组织学比较

目的比较腹壁不同层次线结周围异物巨细胞浸润和纤维化程度，探索打结深度与线结炎症反应的相关性。 方法18只Balb/C小鼠在腹壁左向右分别纵向剪开3个皮肤切口，分别经切口用4-0带针慕斯线进针贯穿缝合腹壁至壁层腹膜不同层次，3个切口处分别打结于皮下、肌层内和腹膜外间隙。术后14和28 d取材打结部位腹壁标本，连续冰冻切片组织学观察。 结果HE染色显示各组线结位于腹壁不同解剖层次内（皮下、肌层和腹膜外间隙）。免疫组织化学和半定量检测显示皮下组线结周围异物巨细胞浸润和纤维化最显著，腹膜外间隙组线结周围异物巨细胞浸润和纤维化最轻微。 结论丝线用于腹壁打结深度与线结异物反应呈相关性；位于腹膜外间隙线结周围引起异物巨细胞浸润和纤维化程度轻微，皮下线结周围异物巨细胞浸润和纤维化程度明显。腹腔镜经皮腹膜外内环结扎术中将线结打在腹膜外间隙，有利于降低线结炎症反应和线结反应相关并发症的发生率，并为其提供理论依据。

Morphological comparative study of knot-induced foreign giant cells infiltration and fibrosis in differential level of mice abdominal wall

ObjectiveKnot-induced inflammatory response can be seen in percutaneous extracorporeal knotting for laparoscopic inguinal inner ring closure in children. The present study aimed to investigate the correlation between knot-induced foreign giant cells infiltration and fibrosis in mice abdominal wall. Methods28 mice were targeted; three vertical and parallel incisions were created in abdominal wall in same Balb/C mice, followed by saturation with 1 mm stitch using MERSILK^? non-absorbable suture. The knots were respectively resided in subcutaneous, intramuscular and extra peritoneal layer in abdominal wall. The knot segments in each group were harvested at day 14 and day 28 post-operation. HE, IHC staining and Masson staining were conducted to investigate the location of knots in each group, foreign giant cells infiltration and collagen deposition around knots in each group. ResultsH&E staining indicated that the knot was made accurately subcutaneous, intramuscular and extra peritoneal space in abdominal wall. The immunohistochemistry staining indicated less foreign giant cells infiltration and collagen deposition in extra peritoneal space in abdominal wall. On the contrary, more foreign giant cells infiltration and increased collagen production could be noted in subcutaneous layer. ConclusionOur studies show the correlation between knot-induced long term of inflammatory responses and differential knot location in mice abdominal wall in mice. Knot in extra peritoneal space induced slight foreign inflammation and fibrosis in abdominal wall, compared with other subcutaneous and intramuscular layers. Our study further supported that knotting in extracorporeal knotting procedure for inguinal hernia in children, has potential to cause slight knot-induced inflammation.