A simplified method to evaluate the loss of domain
Abdul Rahman Al Sadairi1,2, Jules Durtette-Guzylack3, Arnaud Renard4
1Department of General, Digestive and Endocrine Surgery, Robert-Debré University Hospital, University of Reims Champagne-Ardenne, Rue Cognac-Jay, 51092, Reims Cedex, France. alsideiriab@gmail.com.
Hernia : the Journal of Hernias and Abdominal Wall Surgery
|August 3, 2021
Summary
A new, simple method using CT scans can quickly determine the loss of domain ratio for giant incisional hernias. This helps surgeons predict and manage post-operative complications before surgery.
Area of Science:
- Abdominal surgery
- Radiology
- Medical imaging analysis
Background:
- Giant incisional hernias with loss of domain (IHLD) present significant surgical challenges.
- Accurate preoperative assessment of abdominal cavity (AC) and incisional hernia (IH) volumes is crucial for predicting post-operative complications.
- Existing methods like Tanaka's and Sabbagh's are time-consuming and require specialized software.
Purpose of the Study:
- To develop a simple and rapid method for calculating the loss of domain ratio (LOD-ratio) from preoperative CT scans.
- To provide surgeons with a tool for anticipating post-operative risks associated with IHLD repair.
Main Methods:
- Retrospective analysis of 89 CT scans from patients with IHLD.
- Calculation of various ratios using IH and AC dimensions, areas (axial, sagittal ellipse, freehand), and comparison with established methods (Sabbagh, Tanaka).
- Development of novel "R-ratios" (Reims-ratios) using freehand ROI on sagittal views or ellipse on axial views.
Main Results:
- Reference methods (Sabbagh and Tanaka) yielded comparable LOD ratios (ICC = 0.82).
- The new R-ratios demonstrated excellent correlation with both reference methods (ICC ≥ 0.71).
- R-ratios can be rapidly calculated using simple measurements on CT scans.
Conclusions:
- The "R-ratios" provide a quick and reliable way to assess the LOD ratio from preoperative CT scans.
- This simplified method can aid surgeons in routinely anticipating and managing post-operative complications before IHLD repair.
- A web-based tool is available for calculating R-ratios: https://romeo.univ-reims.fr/Rratio/
Keywords:
Abdominal cavity volumeComputerized tomographyGiant incisional herniaIncisional herniaR-ratios (Reims-ratio)RecurrenceMore Related Videos
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