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Surgical Endoscopy

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01-03-2022 | Computed Tomography

Validation of a simple technique of volumetric analysis of complex incisional hernias without 3D CT scan reconstruction

Authors: Mazen R. Al-Mansour, Jacqueline Wu, Greg Gagnon, Alexander Knee, John Romanelli, Neal E. Seymour

Published in: Surgical Endoscopy | Issue 3/2022

Abstract

Purpose

Volumetric analysis is being increasingly utilized in the preoperative evaluation of complex incisional hernias. Three-dimensional (3D) reconstruction of abdominal computed tomography (CT) scan has been used to obtain surface area (SA) and volume (Vol.) measurements, while others have used simple mathematical formulas to obtain SA and Vol. estimates without 3D reconstruction. Our objective was to assess the correlation of SA and Vol. measurements and estimates of complex incisional hernias.

Methods

We conducted a retrospective agreement study of adults who underwent abdominal wall reconstruction from 2007 to 2018. Demographics, hernia characteristics, and operative data were collected from the medical record.

SA and Vol. measurements were obtained after 3D CT reconstruction. Linear CT variables were obtained independently by two surgeons and SA and Vol. estimates were calculated. Because both surgeons reported similar results, only lead author values are reported in the abstract. We used Pearson’s correlation coefficient (r) to assess inter-rater agreement and the agreement between SA and Vol. measurements and estimates.

Results

A total of 108 patients were eligible for analysis. The mean age was 57 ± 11 years and 53 (49%) were female. 42 (39%) hernias were recurrent, 10 (9%) patients had a stoma, and 9 (8%) had a history of open abdomen. The mean defect width was 11 ± 4 cm and mean defect surface area (DSA) was 150 ± 95 cm². Inter-rater agreement of SA and Vol. estimates was high (r ≥ 0.80). There was high correlation between SA and Vol. measurements and estimates for DSA, hernia sac volume (HSV), abdominal cavity volume (ACV), and HSV/ACV ratio (r = 0.81, 0.89, 0.94 and 0.91, respectively).

Conclusion

SA and Vol. estimates demonstrated high level of agreement with SA and Vol. measurements using 3D reconstruction. SA and Vol. estimates can be obtained using simple mathematical formulas using easily obtained linear variables negating the need for the time and effort consuming 3D reconstruction.

Blair LJ, Ross SW, Huntington CR et al (2015) Computed tomographic measurements predict component separation in ventral hernia repair. J Surg Res 199:420–427. https://doi.org/10.1016/j.jss.2015.06.033CrossRefPubMed

Franklin BR, Patel KM, Nahabedian MY et al (2013) Predicting abdominal closure after component separation for complex ventral hernias: maximizing the use of preoperative computed tomography. Ann Plast Surg 71:261–265. https://doi.org/10.1097/SAP.0b013e3182773915CrossRefPubMed

Winters H, Knaapen L, Buyne OR et al (2019) Pre-operative CT scan measurements for predicting complications in patients undergoing complex ventral hernia repair using the component separation technique. Hernia 23:347–354. https://doi.org/10.1007/s10029-019-01899-8CrossRefPubMedPubMedCentral

Schlosser KA, Maloney SR, Prasad T et al (2019) Three-dimensional hernia analysis: the impact of size on surgical outcomes. Surg Endosc. https://doi.org/10.1007/s00464-019-06931-7CrossRefPubMed

Schlosser KA, Maloney SR, Prasad T et al (2019) Too big to breathe: predictors of respiratory failure and insufficiency after open ventral hernia repair. Surg Endosc. https://doi.org/10.1007/s00464-019-07181-3CrossRefPubMed

Sabbagh C, Dumont F, Robert B et al (2011) Peritoneal volume is predictive of tension-free fascia closure of large incisional hernias with loss of domain: a prospective study. Hernia 15:559–565. https://doi.org/10.1007/s10029-011-0832-yCrossRefPubMed

Martre P, Sarsam M, Tuech J-J et al (2019) New, simple and reliable volumetric calculation technique in incisional hernias with loss of domain. Hernia. https://doi.org/10.1007/s10029-019-01990-0CrossRefPubMed

Tanaka EY, Yoo JH, Rodrigues AJ et al (2010) A computerized tomography scan method for calculating the hernia sac and abdominal cavity volume in complex large incisional hernia with loss of domain. Hernia 14:63–69. https://doi.org/10.1007/s10029-009-0560-8CrossRefPubMed

Al-Mansour MR, Wu J, Gagnon G et al (2021) Linear versus volumetric CT analysis in predicting tension-free fascial closure in abdominal wall reconstruction. Hernia. https://doi.org/10.1007/s10029-020-02349-6CrossRefPubMed

10.

Harris PA, Taylor R, Thielke R et al (2009) Research electronic data capture (REDCap)–a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform 42:377–381. https://doi.org/10.1016/j.jbi.2008.08.010CrossRefPubMed

11.

Muysoms FE, Miserez M, Berrevoet F et al (2009) Classification of primary and incisional abdominal wall hernias. Hernia 13:407–414. https://doi.org/10.1007/s10029-009-0518-xCrossRefPubMedPubMedCentral

12.

Sabbagh C, Dumont F, Fuks D et al (2012) Progressive preoperative pneumoperitoneum preparation (the Goni Moreno protocol) prior to large incisional hernia surgery: volumetric, respiratory and clinical impacts. A prospective study. Hernia 16:33–40. https://doi.org/10.1007/s10029-011-0849-2CrossRefPubMed

Title: Validation of a simple technique of volumetric analysis of complex incisional hernias without 3D CT scan reconstruction
Authors: Mazen R. Al-Mansour
Jacqueline Wu
Greg Gagnon
Alexander Knee
John Romanelli
Neal E. Seymour
Publication date: 01-03-2022
Publisher: Springer US
Keywords: Computed Tomography
Computed Tomography
Incisional Hernia
Published in: Surgical Endoscopy / Issue 3/2022
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-021-08476-0

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Validation of a simple technique of volumetric analysis of complex incisional hernias without 3D CT scan reconstruction

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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