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Hernia
Published in: Hernia 2/2019

Open Access 01-04-2019 | Computed Tomography | Original Article

Pre-operative CT scan measurements for predicting complications in patients undergoing complex ventral hernia repair using the component separation technique

Authors: H. Winters, L. Knaapen, O. R. Buyne, S. Hummelink, D. J. O. Ulrich, H. van Goor, E. van Geffen, N. J. Slater

Published in: Hernia | Issue 2/2019

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Abstract

Background

The component separation technique (CST) is considered an excellent technique for complex ventral hernia repair. However, postoperative infectious complications and reherniation rates are significant. Risk factor analysis for postoperative complication and reherniation has focused mostly on patient history and co-morbidity and shows equivocal results. The use of abdominal morphometrics derived from CT scans to assist in risk assessment seems promising. The aim of this study is to determine the predictability of reherniation and surgical site infections (SSI) using pre-operative CT measurements.

Methods

Electronic patient records were searched for patients who underwent CST between 2000 and 2013 and had a pre-operative CT scan available. Visceral fat volume (VFV), subcutaneous fat volume (SFV), loss of domain (LOD), rectus thickness and width (RT, RW), abdominal volume, hernia sac volume, total fat volume (TFV), sagittal distance (SD) and waist circumference (WC) were measured or calculated. Relevant variables were entered in multivariate regression analysis to determine their effect on reherniation and SSI as separate outcomes.

Results

Sixty-five patients were included. VFV (p = 0.025, OR = 1.65) was a significant predictor regarding reherniation. Hernia sac volume (p = 0.020, OR = 2.10) and SFV per 1000 cm3 (p = 0.034, OR = 0.26) were significant predictors of SSI.

Conclusion

Visceral fat volume, subcutaneous fat volume and hernia sac volume derived from CT scan measurements may be used to predict reherniation and SSI in patients undergoing complex ventral hernia repair using CST. These findings may aid in optimizing patient-tailored preoperative risk assessment.
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Metadata
Title
Pre-operative CT scan measurements for predicting complications in patients undergoing complex ventral hernia repair using the component separation technique
Authors
H. Winters
L. Knaapen
O. R. Buyne
S. Hummelink
D. J. O. Ulrich
H. van Goor
E. van Geffen
N. J. Slater
Publication date
01-04-2019
Publisher
Springer Paris
Published in
Hernia / Issue 2/2019
Print ISSN: 1265-4906
Electronic ISSN: 1248-9204
DOI
https://doi.org/10.1007/s10029-019-01899-8

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