Significance of measurements of herniary area and volume and abdominal cavity volume in the treatment of incisional hernia: application of CT 3D reconstruction in 17 cases.

Abstract

Objective: To investigate the value of CT 3D reconstruction in the diagnosis and treatment of incisional hernia and the related factor of abdominal cavity volume.

Methods: Abdominal wall defect and herniary volume were measured using 3D reconstruction based on plain CT scans in 17 patients with incisional hernias.

Results: The herniary diameter, area and volume could be measured in the 17 patients and the abdominal cavity volume was also measured in 10 patients using the 3D reconstruction technique. The correlation indices of the abdominal cavity volume with the patient's height, weight and body mass index (BMI) were all less than 0.01.

Conclusion: Herniary area and volume and abdominal cavity volume can be accurately calculated through CT 3D reconstruction. The patch area should be more than 5 times as large as the defect area; combined with the perioperative overlap margin measurement method, this results in more scientific surgical management. The ratio of the herniary volume to the abdominal cavity volume may be conducive to preoperative assessment of the risk of abdominal compartment syndrome (ACS); however, the ratio that may lead to postoperative ACS remains to be determined. There are correlations of abdominal cavity volume with patient height, weight and BMI, especially with weight. We therefore propose that the abdominal cavity volume should be evaluated with internationally accepted indices.