切口疝壁重建后腹壁肌肉的变化。

IF 2.6 2区 医学 Q1 SURGERY
Hernia Pub Date : 2024-10-01 Epub Date: 2024-03-22 DOI:10.1007/s10029-024-02969-2
Z Wang, X Wang, C Wang, Y Zhao
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引用次数: 0

摘要

目的:切口疝手术的目的是恢复腹壁的解剖和生理功能。本研究旨在通过测量切口疝修补术患者术前和术后腹壁肌肉的变化,研究腹壁重建对腹壁肌肉改变的影响:方法:对接受开腹切口疝腹壁重建术的患者进行术前和术后腹部 CT 扫描分析,扫描时间至少为术后 3 个月。利用 3D Slicer 软件测量术前和术后腹腔容积、腹肌容积以及特定层面的肌肉容积、横截面积和腹围的变化。获得的数据使用 SPSS 软件进行统计分析:共有 40 名符合纳入标准的患者接受了开腹切口疝修补手术。其中一些患者由于疝囊较大,需要采用组件分离技术(CST)。疝环周围的腹肌被定义为 "受损组",而其余腹肌被定义为 "未受损组"。测量结果显示,受损组腹直肌、腹外斜肌、腹内斜肌和腹横肌的体积明显增加。同样,未受损组的腹直肌、腹外斜肌、腹内斜肌和腹横肌的体积也相应增加:切口疝患者腹壁重建后,不仅解剖结构得到恢复,腹壁的整体生物力学完整性也得到修复。受损的肌肉重新承受负荷,导致废用性萎缩的逆转和肌肉体积的增加。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

The changes in abdominal wall muscles following incisional hernia wall reconstruction.

The changes in abdominal wall muscles following incisional hernia wall reconstruction.

Purpose: The objective of incisional hernia surgery is to achieve the restoration of abdominal wall anatomical and physiological functions. This study aims to investigate the impact of abdominal wall reconstruction on abdominal muscle alterations by measuring the preoperative and postoperative changes in abdominal wall muscles in patients undergoing incisional hernia repair.

Methods: For patients undergoing open incisional hernia abdominal wall reconstruction, preoperative and postoperative abdominal CT scans were analyzed at a minimum of 3 months post-surgery. 3D Slicer software was utilized for measuring preoperative and postoperative changes in abdominal cavity volume, abdominal muscle volume, as well as muscle volume, cross-sectional area, and abdominal circumference at specific levels. The acquired data were subjected to statistical analysis using SPSS software.

Results: A total of 40 patients meeting the inclusion criteria underwent open incisional hernia repair surgery. Some of these patients required component separation technique (CST) due to the larger size of the hernia sac. The abdominal muscles surrounding the hernia ring were defined as the "damaged group," while the remaining abdominal muscles were defined as the "undamaged group." Measurements revealed a significant increase in the volume of rectus abdominis, external oblique, internal oblique, and transversus abdominis muscles in the damaged group. Similarly, there was a corresponding increase in the volume of rectus abdominis, external oblique, internal oblique, and transversus abdominis muscles in the undamaged group.

Conclusions: After abdominal wall reconstruction in incisional hernia patients, not only is their anatomical structure restored, but the overall biomechanical integrity of the abdominal wall is also repaired. The damaged muscles are subjected to renewed loading, leading to the reversal of disuse atrophy and an increase in muscle volume.

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来源期刊
Hernia
Hernia SURGERY-
CiteScore
4.90
自引率
26.10%
发文量
171
审稿时长
4-8 weeks
期刊介绍: Hernia was founded in 1997 by Jean P. Chevrel with the purpose of promoting clinical studies and basic research as they apply to groin hernias and the abdominal wall . Since that time, a true revolution in the field of hernia studies has transformed the field from a ”simple” disease to one that is very specialized. While the majority of surgeries for primary inguinal and abdominal wall hernia are performed in hospitals worldwide, complex situations such as multi recurrences, complications, abdominal wall reconstructions and others are being studied and treated in specialist centers. As a result, major institutions and societies are creating specific parameters and criteria to better address the complexities of hernia surgery. Hernia is a journal written by surgeons who have made abdominal wall surgery their specific field of interest, but we will consider publishing content from any surgeon who wishes to improve the science of this field. The Journal aims to ensure that hernia surgery is safer and easier for surgeons as well as patients, and provides a forum to all surgeons in the exchange of new ideas, results, and important research that is the basis of professional activity.
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