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02.08.2021 | Original Article

A simplified method to evaluate the loss of domain

verfasst von: Abdul Rahman Al Sadairi, Jules Durtette-Guzylack, Arnaud Renard, Carole Durot, Aurore Thierry, Reza Kianmanesh, Guillaume Passot, Yohann Renard

Erschienen in: Hernia | Ausgabe 3/2022

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Abstract

Purpose

The treatment of giant incisional hernia (IH) with loss of domain (LOD, IHLD) is considerably challenging due to technical difficulties and subsequent post-operative complications. These post-operative risks may be anticipated by calculating the abdominal cavity (AC) volume (ACV) and the IH volume (IHV) on the preoperative CT-scans, using the AC and IH dimensions (Tanaka’s method) or using tridimensional volumetry (Sabbagh’s method). These techniques are often time-consuming and require specific softwares. The aim of the present study was to develop a simple method to rapidly obtain the LOD-ratio on the preoperative CT-Scan.

Methods

The CT-scans (n = 89) of patients with IHLD were retrospectively studied. Several ratios were calculated using different parameters of the AC and the IH, including width, height and depth, the areas (axial and sagittal ellipse, as well as freehand sagittal surface areas) and these were compared with the reference methods of Sabbagh et al. and Tanaka et al.

Results

The LOD ratios calculated from the two reference methods gave similar results (ICC = 0.82, p < 0.0001). The new “R-ratios” (Reims-ratios) obtained from the IH and AC surface areas measured using the “freehand ROI” tool on sagittal view or roughly evaluated by an ellipse on axial view showed excellent correlation with both reference ratios (all ICC ≥ 0.71, p < 0.0001).

Conclusion

The LOD ratio may be quickly obtained by drawing two circles on the pre-operative CT scan (“R ratios”) and available on the webpage https://romeo.univ-reims.fr/Rratio/. This will certainly help surgeons to routinely anticipate the post-operative complications before IHLD repair.

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Titel: A simplified method to evaluate the loss of domain
verfasst von: Abdul Rahman Al Sadairi
Jules Durtette-Guzylack
Arnaud Renard
Carole Durot
Aurore Thierry
Reza Kianmanesh
Guillaume Passot
Yohann Renard
Publikationsdatum: 02.08.2021
Verlag: Springer Paris
Erschienen in: Hernia / Ausgabe 3/2022
Print ISSN: 1265-4906
Elektronische ISSN: 1248-9204
DOI: https://doi.org/10.1007/s10029-021-02474-w

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