From the Journals

CT may predict complications after complex ventral hernia repair



Information obtained from computed tomography (CT) scans may help predict reherniation and surgical site infection (SSI) in patients who had complex ventral hernia repair with the component separation technique (CST), according to findings published in Hernia.

A surgeon operates on a patient jacoblund/Thinkstock

In a study of 65 adults who had a CT performed before CST, visceral fat volume was a significant predictor of reherniation (P = .025, odds ratio 1.65), reported Harm Winters of the department of plastic and reconstructive surgery at Radboud University Medical Center, Nijmegen, the Netherlands, and coauthors.

Patients were 18-75 years of age, and had complex ventral hernia repair via CST between 2000 and 2013. Patients were excluded if the CT scan was performed earlier than 6 months before hernia repair, or if the scan did not cover the full abdomen.

Visceral fat volume, subcutaneous fat volume, loss of domain, rectus thickness and width, abdominal volume, hernia sac volume, total fat volume, sagittal distance, and waist circumference were measured. Mesh reinforcement during surgery was used in 45 patients (69.2%), the authors noted.

Hernia sac volume and subcutaneous fat volume per 1,000 cm3 were significant predictors of surgical site infection (P = .020, OR 2.10 and P = .034, OR 0.26, respectively).

“These findings suggest that CT measurements are a valuable tool for preoperative risk assessment in patients undergoing complex ventral hernia repair using the CST,” the researchers wrote. Future trials should “further identify the role of these CT scan-derived body morphometrics for patient-tailored risk assessment,” they concluded.

No conflicts of interest were reported.

SOURCE: Winters H et al. Hernia. 2019 Mar 7. doi: 10.1007/s10029-019-01899-8.

Recommended Reading

Elective hernia repair preferable in patients with chronic liver disease
MDedge Surgery
Clinical trial: Randomized study of lap vs. robotic hernia surgery underway
MDedge Surgery
Outcomes similar for skin graft, synthetic mesh in incisional hernia repair
MDedge Surgery
Pregnancy after ventral hernia repair increased the risk for recurrence
MDedge Surgery
Evidence weak for robotic inguinal hernia surgery
MDedge Surgery