基于多载体计算机断层扫描的成分分离指数在腹股沟大疝治疗中的作用。

IF 0.4 4区 医学 Q4 SURGERY
South African Journal of Surgery Pub Date : 2024-10-01
D Sharma, V Upadhyay, U C Garga, R Lal
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引用次数: 0

摘要

背景:预测大的腹股沟疝在没有成分分离(CS)的情况下完全闭合可能具有临床价值。方法:在 60 例腹股沟疝患者中,根据他们的 MDCT 计算出 CSI:方法:在 60 名腹股沟疝患者中,根据他们的 MDCT 计算 CSI。在第一组(前 30 名患者)中,疝修补术通过开放式方法进行,手术评估决定是否需要进行 CS 以实现完全闭合。CSI 参考值为缺陷闭合需要 CS 时的 CSI 值。在第二组(第二组 30 名患者)中,疝修补术是通过腹腔镜完成的。CSI 值达到或低于第一组参考点的患者在直接闭合缺损(IPOM-plus)后接受腹腔内嵌网术(IPOM)。其他患者则在进入腹腔前进行双侧内窥镜组件分离(ECS),以达到IPOM-plus的目的:结果:开腹和腹腔镜方法的 CSI 分别超过 0.067 和 0.044 时,需要进行 CS 以完全闭合缺损。开腹法和腹腔镜法的 CSI 分别高于 0.25 和 0.125,尽管进行了 CS,但仍预示无法完全闭合缺损:结论:与传统的二维参数相比,CSI 是评估腹股沟疝更全面的参数,可以预测在腹腔镜和开腹手术中完全闭合缺损前是否需要进行组件分离。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Role of multidetector computed tomographybased component separation index in the management of large ventral hernias.

Background: Predicting complete closure of large ventral hernias without component separation (CS) could have clinical value. The utility of multidetector computed tomography (MDCT)-based component separation index (CSI) was derived and evaluated for these hernias.

Methods: In 60 patients with a ventral hernia, a CSI was calculated based on their MDCT. In group I (first 30 patients), hernia repair was performed by an open approach and operative assessment determined the need for CS to effect complete closure. A CSI value above which defect closure needed CS was taken as the CSI reference point. In group II (second 30 patients), the hernia repair was done laparoscopically. Patients with a CSI at or below the reference point of group I underwent intraperitoneal onlay mesh (IPOM) after direct closure of the defect (IPOM-plus). The other patients had bilateral endoscopic component separation (ECS) before entry into the peritoneal cavity for an intended IPOM-plus.

Results: A CSI above 0.067 and 0.044 in open and laparoscopic approaches respectively required CS for complete defect closure. A CSI above 0.25 and 0.125 in open and laparoscopic approaches respectively, despite CS, predicted complete closure of defect was not possible.

Conclusion: CSI is a more comprehensive parameter for evaluation of ventral hernia than the conventional twodimensional parameters and can predict the need of component separation prior to complete closure of the defect in both laparoscopic and open approach.

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来源期刊
CiteScore
0.80
自引率
20.00%
发文量
43
审稿时长
>12 weeks
期刊介绍: The South African Journal of Surgery (SAJS) is a quarterly, general surgical journal. It carries research articles and letters, editorials, clinical practice and other surgical articles and personal opinion, South African health-related news, obituaries and general correspondence.
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