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
{"title":"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。","authors":"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","doi":"10.1007/s10029-025-03440-6","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"266"},"PeriodicalIF":2.4000,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"3D tomographic reconstruction in complex ventral hernias. Does it make a difference? Subjective evaluation of surgeons.\",\"authors\":\"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\",\"doi\":\"10.1007/s10029-025-03440-6\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>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.</p>\",\"PeriodicalId\":13168,\"journal\":{\"name\":\"Hernia\",\"volume\":\"29 1\",\"pages\":\"266\"},\"PeriodicalIF\":2.4000,\"publicationDate\":\"2025-08-29\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Hernia\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s10029-025-03440-6\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"SURGERY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Hernia","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s10029-025-03440-6","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"SURGERY","Score":null,"Total":0}
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.
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.