Introduction : The interest in vascular substitutes has recently increased. We evaluated the feasibility of using a homologous parietal peritoneum (HPP) as a vascular substitute for venous reconstruction during abdominal surgery.

Methods : The inferior vena cava was replaced with an HPP after cross-linking with glutaraldehyde in 15 rabbits. At 7, 14, and 28 days, the patency rate, outer and inner graft diameters, histology, and immunohistochemistry were evaluated.

Results : Both the 7- and 14-day groups maintained vascular patency. Vascular patency was maintained in three rabbits in the 28-day group. The inner diameters of the anastomotic sites were 6.12 ?0.20, 5.63 ?0.14, and 2.22 ?0.23 mm in the 7-day, 14-day, and 28-day groups, respectively. The mid-point inner diameters of the HPP grafts were 6.21 ?0.13, 5.82 ?0.16, and 2.12 ?0.24 mm in each group, respectively. Endothelial cell proliferation on the HPP graft surfaces in all groups was based on the histological findings from the first group. Multiple neo-vascularizations of the HPP graft were found in the 14- and 28-day groups, indicating neo-media formation. Acute inflammation appeared to progress to the entire layer of the HPP graft without an intraluminal thrombus, but the graft was patent in the 14-day group. In the 28-day group, two rabbits showed near-total occlusion and a thrombus formed in the HPP graft at the anastomosis site with severe stricture; however, the rabbits were alive and had collateral vessel formation.

Conclusions : Use of the HPP is feasible for venous reconstruction in abdominal surgery.