复杂腹疝的三维断层重建。这有什么区别吗?外科医生的主观评价。

IF 2.4 2区 医学 Q1 SURGERY
Hernia Pub Date : 2025-08-29 DOI:10.1007/s10029-025-03440-6
Bruno de Lima Rodrigues, Marcelo Gonçalves de Oliveira, Diego Paim Carvalho Garcia, Gustavo Soares, Bruna Flávia Cesario Senna, Henrique Araújo Lima, Fabiana Paiva Martins, Eliney Ferreira Faria
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引用次数: 0

摘要

目的:腹疝是一种外科挑战,通常需要详细的影像学来制定手术计划。计算机断层扫描(CT)广泛应用于术前评估,三维重建在外科领域的应用越来越广泛。本研究旨在评估与传统二维(2D) CT相比,3D CT重建是否能改善手术计划。方法:从2024年10月至2025年1月进行横断面调查,纳入66名不同经验的外科医生。参与者被随机分为两组:一组使用常规CT评估复杂的腹疝,另一组使用2D和3D重建。根据DECOMP标准、外科医生对疝特征的认知、手术计划和治疗策略,通过问卷收集数据。统计学分析包括Fisher精确检验、卡方检验和ROC曲线分析。结果:两组在疝评估、术前计划或手术入路方面无显著差异。外科医生主要依靠个人对CT扫描的解读,而不是放射学报告。值得注意的是,3D重建降低了对疝囊网膜内容物的感知(74.2%对97.1%,p = 0.01)。此外,3D可视化并没有改变手术决策,包括网格选择、组件分离或术前技术的失域。结论:与2D CT相比,3D CT重建对复杂腹疝的评估和手术计划没有影响。虽然三维成像可以增强解剖可视化,但其临床应用尚不清楚。经过仔细分析,传统的二维CT仍然足以用于手术决策。需要进一步的研究来评估3D成像的好处。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
3D tomographic reconstruction in complex ventral hernias. Does it make a difference? Subjective evaluation of surgeons.

Purpose: Ventral hernias are a surgical challenge, often requiring detailed imaging for surgical planning. Computed tomography (CT) is widely used in preoperative assessment, with three-dimensional (3D) reconstructions increasingly applied in surgical fields. This study aims to assess whether 3D CT reconstructions improve surgical planning compared to conventional two-dimensional (2D) CT.

Methods: A cross-sectional survey was conducted from October 2024 to January 2025, enrolling 66 surgeons with diverse experience. Participants were randomized into two groups: one assessing a complex ventral hernia using conventional CT and the other using both 2D and 3D reconstructions. Data were collected through questionnaires based on the DECOMP criteria, surgeons' perception of hernia characteristics, surgical planning, and treatment strategies. Statistical analyses, including Fisher's exact test, Chi-square test, and ROC curve analysis, were performed to compare outcomes.

Results: No significant differences were found between the groups in the evaluation of the hernia, preoperative planning, or surgical approach. Surgeons predominantly relied on personal interpretation of CT scans rather than radiology reports. Notably, 3D reconstructions decreased the perception of hernia sac omental content (74.2% vs. 97.1%, p = 0.01). Furthermore, 3D visualization did not alter surgical decisions, including mesh selection, component separation, or preoperative techniques for loss of domain.

Conclusion: 3D CT reconstructions do not impact the evaluation or surgical planning of complex ventral hernias compared to 2D CT. Although 3D imaging may enhance anatomical visualization, its clinical utility is unclear. Conventional 2D CT, when carefully analyzed, remains sufficient for surgical decision-making. Further research is needed to assess 3D imaging's benefits.

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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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