A simplified method to evaluate the loss of domain

• Published in: Hernia : the journal of hernias and abdominal wall surgery 2022-06, Vol.26 (3), p.927-936
• Main Authors: Al Sadairi, Abdul Rahman, Durtette-Guzylack, Jules, Renard, Arnaud, Durot, Carole, Thierry, Aurore, Kianmanesh, Reza, Passot, Guillaume, Renard, Yohann
• Format: Article
• Language: English
• Subjects: Abdominal Cavity - surgery; Abdominal Surgery; Complications; Computed tomography; Hernia; Herniorrhaphy - methods; Human health and pathology; Humans; Incisional Hernia - surgery; Life Sciences; Medicine; Medicine & Public Health; Original Article; Postoperative; Postoperative Complications - etiology; Postoperative Complications - surgery; Ratios; Retrospective Studies; Surface area; Tomography, X-Ray Computed - methods
• ISSN: 1265-4906; 1248-9204
• DOI: 10.1007/s10029-021-02474-w

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