中国实用外科杂志2025，Vol.45Issue(4)：457-460,4.DOI:10.19538/j.cjps.issn1005-2208.2025.04.13
应用CT三维重建技术评估肥胖对切口疝修补术后腹壁功能恢复及疝复发影响研究
The impact of obesity on the recovery of abdominal wall and possibility of recurrence after incisional hernia repair:A 3D reconstruction-based retrospective study
摘要
Abstract
Objective To analyze the impact of obesity on the recovery of the rectus abdominis muscle after mesh repair of incisional hernia via establishing an objective method with computed tomography(CT)scan-based 3D reconstruction technology,and to investigate the mechanism underlying the elevated recurrence rate associated with obesity.Methods A retrospective analysis was conducted on the clinical data from 73 patients with abdominal incisional hernia(maximum defect diameter ≥4 cm)who underwent mesh repair at the Department of General Surgery,Huadong Hospital affiliated to Fudan University between February 2023 and August 2024,and had a postoperative period exceeding 3 months.Patients were stratified into three groups based on BMI:normal group(18.5-＜24.0),overweight group(24.0-＜28.0),and obesity group(≥28.0).Preoperative and postoperative abdominal CT images were reconstructed three-dimensionally using 3D Slicer software(version 5.7.0)to quantify rectus abdominis muscle volume.Results 3D reconstruction imaging of the abdominal wall in incisional hernia patients following mesh repair demonstrated improved morphological uniformity of the abdominal wall and partial anatomical and functional recovery of the rectus abdominis muscle accompanied by a significant volume increase.No statistically significant intergroup differences were observed in absolute preoperative-to-postoperative volume increments of rectus abdominis muscle among the three cohorts(P＞0.05).The normal group exhibited a greater percentage increase in rectus abdominis muscle volume compared to the overweight and obesity groups[(12.1±2.2)％vs.(9.4±1.6)％vs.(7.9±2.0)％)],with statistically significant pairwise differences(t=5.159 and 6.059,P＜0.05).Conclusion The 3D reconstruction indicates that the obesity significantly reduces the recovery ability of the rectus abdominis muscle in patients with incisional hernia after mesh repair,suggesting that obesity-induced impairment of muscle recovery is a potential mechanism for the increased recurrence rate in obese patients.关键词
肥胖/切口疝/腹直肌体积/三维重建/疝复发Key words
obesity/incisional hernia/rectus abdominis muscle volume/3D reconstruction/hernia recurrence分类
医药卫生引用本文复制引用
杨荣铎,李绍春,孟云潇,黄磊,蔡昭,唐健雄,李绍杰..应用CT三维重建技术评估肥胖对切口疝修补术后腹壁功能恢复及疝复发影响研究[J].中国实用外科杂志,2025,45(4):457-460,4.基金项目
Healthcare-Industry Innovation Transfer Fund of Shanghai Shenkang Hospital Development Center(No.SHDC2022CRT021) 上海申康医院发展中心医企融合创新成果转化专项(No.SHDC2022CRT021) （No.SHDC2022CRT021）
