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Van den Dop LM, Van Rooijen MMJ, Tollens T, Jørgensen LN, De Vries-Reilingh TS, Piessen G, Köckerling F, Miserez M, Dean M, Berrevoet F, Dousset B, Van Westreenen HL, Gossetti F, Tetteroo GWM, Koch A, Boomsma MF, Lange JF, Jeekel J. Five-Year Follow-Up of a Slowly Resorbable Biosynthetic P4HB Mesh (Phasix) in VHWG Grade 3 Incisional Hernia Repair. Ann Surg Open 2023; 4:e366. [PMID: 38144487 PMCID: PMC10735126 DOI: 10.1097/as9.0000000000000366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 11/02/2023] [Indexed: 12/26/2023] Open
Abstract
Objective To assess the 5-year recurrence rate of incisional hernia repair in Ventral Hernia Working Group (VHWG) 3 hernia with a slowly resorbable mesh. Summary Background Data Incisional hernia recurs frequently after initial repair. In potentially contaminated hernia, recurrences rise to 40%. Recently, the biosynthetic Phasix mesh has been developed that is resorbed in 12-18 months. Resorbable meshes might be a solution for incisional hernia repair to decrease short- and long-term (mesh) complications. However, long-term outcomes after resorption are scarce. Methods Patients with VHWG grade 3 incisional midline hernia, who participated in the Phasix trial (Clinilcaltrials.gov: NCT02720042) were included by means of physical examination and computed tomography (CT). Primary outcome was hernia recurrence; secondary outcomes comprised of long-term mesh complications, reoperations, and abdominal wall pain [visual analogue score (VAS): 0-10]. Results In total, 61/84 (72.6%) patients were seen. Median follow-up time was 60.0 [interquartile range (IQR): 55-64] months. CT scan was made in 39 patients (68.4%). A recurrence rate of 15.9% (95% confidence interval: 6.9-24.8) was calculated after 5 years. Four new recurrences (6.6%) were found between 2 and 5 years. Two were asymptomatic. In total, 13/84 recurrences were found. No long-term mesh complications and/or interventions occurred. VAS scores were 0 (IQR: 0-2). Conclusions Hernia repair with Phasix mesh in high-risk patients (VHWG 3, body mass index >28) demonstrated a recurrence rate of 15.9%, low pain scores, no mesh-related complications or reoperations for chronic pain between the 2- and 5-year follow-up. Four new recurrences occurred, 2 were asymptomatic. The poly-4-hydroxybutyrate mesh is a safe mesh for hernia repair in VHWG 3 patients, which avoids long-term mesh complications like pain and mesh infection.
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Affiliation(s)
- L M Van den Dop
- From the Department of Surgery, Erasmus University Medical Centre, Rotterdam, the Netherlands
| | - M M J Van Rooijen
- From the Department of Surgery, Erasmus University Medical Centre, Rotterdam, the Netherlands
| | - T Tollens
- Department of Surgery, Imelda Hospital, Bonheiden, Belgium
| | - L N Jørgensen
- Department of Surgery, Bispebjerg Hospital, Copenhagen, Denmark
| | | | - G Piessen
- Department of Surgery, University Hospital Lille, Lille, France
| | - F Köckerling
- Department of Surgery, Vivantes Klinikum Spandau, Berlin, Germany
| | - M Miserez
- Department of Abdominal Surgery, University Hospital Leuven, Leuven, Belgium
| | - M Dean
- Department of Surgery, University College London Hospital, London, United Kingdom
| | - F Berrevoet
- Department of Surgery, University Hospital Gent, Gent, Belgium
| | - B Dousset
- Department of Surgery, Hôpital Cochin, Paris, France
| | | | - F Gossetti
- Department of Surgery, Università di Roma Sapienza, Rome, Italy
| | - G W M Tetteroo
- Department of Surgery, IJsselland Hospital, Capelle aan den IJssel, the Netherlands
| | - A Koch
- Department of Surgery, Chirurgische Praxis Ärztehaus, Cottbus, Germany
| | - M F Boomsma
- Department of Radiology, Isala hospital, Zwolle, the Netherlands
| | - J F Lange
- From the Department of Surgery, Erasmus University Medical Centre, Rotterdam, the Netherlands
| | - J Jeekel
- From the Department of Surgery, Erasmus University Medical Centre, Rotterdam, the Netherlands
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Kareddula A, Medina DJ, Petrosky W, Dolfi S, Tereshchenko I, Walton K, Aviv H, Sadimin E, Tabakin AL, Singer EA, Hirshfield KM. The role of chromodomain helicase DNA binding protein 1 (CHD1) in promoting an invasive prostate cancer phenotype. Ther Adv Urol 2021; 13:17562872211022462. [PMID: 34408788 PMCID: PMC8365013 DOI: 10.1177/17562872211022462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Accepted: 05/15/2021] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Prostate cancer (PCa) phenotypes vary from indolent to aggressive. Molecular subtyping may be useful in predicting aggressive cancers and directing therapy. One such subtype involving deletions of chromodomain helicase DNA binding protein 1 (CHD1), a tumor suppressor gene, are found in 10-26% of PCa tumors. In this study, we evaluate the functional cellular effects that follow CHD1 deletion. METHODS CHD1 was knocked out (KO) in the non-tumorigenic, human papillomavirus 16 (HPV16)-immortalized prostate epithelial cell line, RWPE-1, using CRISPR/Cas9. In vitro assays such as T7 endonuclease assay, western blot, and sequencing were undertaken to characterize the CHD1 KO clones. Morphologic and functional assays for cell adhesion and viability were performed. To study expression of extracellular matrix (ECM) and adhesion molecules, a real-time (RT) profiler assay was performed using RWPE-1 parental, non-target cells (NT2) and CHD1 KO cells. RESULT Compared to parental RWPE-1 and non-target cells (NT2), the CHD1 KO cells had a smaller, rounder morphology and were less adherent under routine culture conditions. Compared to parental cells, CHD1 KO cells showed a reduction in ECM and adhesion molecules as well as a greater proportion of viable suspension cells when cultured on standard tissue culture plates and on plates coated with laminin, fibronectin or collagen I. CHD1 KO cells showed a decrease in the expression of secreted protein acidic and rich in cysteine (SPARC), matrix metalloproteinase 2 (MMP2), integrin subunit alpha 2 (ITGA2), integrin subunit alpha 5 (ITGA5), integrin subunit alpha 6 (ITGA6), fibronectin (FN1), laminin subunit beta-3 precursor (LAMB3), collagen, tenascin and vitronectin as compared to parental and NT2 cells. CONCLUSION These data suggest that in erythroblast transformation specific (ETS) fusion-negative, phosphatase and tensin homolog (PTEN) wildtype PCa, deletion of CHD1 alters cell-cell and cell-matrix adhesion dynamics, suggesting an important role for CHD1 in the development and progression of PCa.
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Affiliation(s)
- Aparna Kareddula
- Department of Medicine, Rutgers Cancer Institute of New Jersey/Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - Daniel J. Medina
- Department of Medicine, Rutgers Cancer Institute of New Jersey/Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - Whitney Petrosky
- Department of Medicine, Rutgers Cancer Institute of New Jersey/Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - Sonia Dolfi
- Department of Medicine, Rutgers Cancer Institute of New Jersey/Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - Irina Tereshchenko
- Department of Medicine, Rutgers Cancer Institute of New Jersey/Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - Kelly Walton
- Department of Medicine/Division of Medical Oncology, Rutgers Cancer Institute of New Jersey/Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - Hana Aviv
- Department of Pathology and Laboratory Medicine, Rutgers -Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - Evita Sadimin
- Section of Urologic Pathology, Rutgers Cancer Institute of New Jersey/Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - Alexandra L. Tabakin
- Section of Urologic Oncology, Rutgers Cancer Institute of New Jersey/Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - Eric A. Singer
- Section of Urologic Oncology, Rutgers Cancer Institute of New Jersey/Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
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Stoikes NFN, Scott JR, Badhwar A, Deeken CR, Voeller GR. Characterization of host response, resorption, and strength properties, and performance in the presence of bacteria for fully absorbable biomaterials for soft tissue repair. Hernia 2017; 21:771-782. [PMID: 28815398 PMCID: PMC5608787 DOI: 10.1007/s10029-017-1638-3] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2016] [Accepted: 08/06/2017] [Indexed: 11/29/2022]
Abstract
PURPOSE The objective was to evaluate the host response, resorption, and strength properties, and to assess the performance in the presence of bacteria for Phasix™ Mesh (Phasix™) and Gore® Bio-A® Tissue Reinforcement (Bio-A®) in preclinical models. METHODS In a rat model, one mesh (2 × 2 cm) was implanted subcutaneously in n = 60 rats. Animals were euthanized after 2, 4, 8, 12, 16, or 24 weeks (n = 5/mesh/time point), and implant sites were assessed for host inflammatory response and overall fibrotic repair thickness. In a rabbit model, meshes (3.8 cm diameter) were bilaterally implanted in subcutaneous pockets in n = 20 rabbits (n = 10 rabbits/mesh) and inoculated with 108 CFU clinically isolated methicillin-resistant Staphylococcus aureus (MRSA). One mesh type was implanted per animal. Animals were euthanized after 7 days, and implants were assessed for abscess formation, bacterial colonization, and mechanical strength. RESULTS In the rat study, Phasix™ and Bio-A® exhibited similar biocompatibility, although Bio-A® demonstrated a significantly greater inflammatory response at 4 weeks compared to Phasix™ (p < 0.01). Morphometric analysis demonstrated rapid resorption of Bio-A® implants with initially thicker repair sites at 2, 4, 8, and 12 weeks (p < 0.0001), which transitioned to significantly thinner sites compared to Phasix™ at 16 and 24 weeks (p < 0.0001). In the rabbit bacterial inoculation study, Phasix™ exhibited significantly lower abscess score (p < 0.001) and bacterial colonization (p < 0.01), with significantly greater mechanical strength than Bio-A® (p < 0.001). CONCLUSIONS Host response, resorption, repair thickness, strength, and bacterial colonization suggest a more stable and favorable outcome for monofilament, macroporous devices such as Phasix™ relative to multifilament, microporous devices such as Bio-A® over time.
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Affiliation(s)
- N F N Stoikes
- Department of Surgery, University of Tennessee Health Science Center, 6029 Walnut Grove Road, Suite 106, Memphis, TN, 38138, USA.
| | - J R Scott
- Department of Molecular Pharmacology, Physiology and Biotechnology, Brown University, Providence, RI, 02906, USA
- C. R. Bard, Inc. (Davol), Warwick, RI, 02886, USA
| | - A Badhwar
- C. R. Bard, Inc. (Davol), Warwick, RI, 02886, USA
| | - C R Deeken
- Covalent Bio, LLC, St. Louis, MO, 63025, USA
| | - G R Voeller
- Department of Surgery, University of Tennessee Health Science Center, 6029 Walnut Grove Road, Suite 106, Memphis, TN, 38138, USA
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