Abstract：
BACKGROUND: The eTEP Rives-Stoppa (RS) procedure, increasingly used for ventral hernia repair, has raised concerns about postoperative upper abdominal bulging. This study aims to objectively evaluate changes in the abdominal contour after eTEP RS and explore potential causes using a novel analytical tool, the Ellipse 9.
METHODS: Thirty patients undergoing eTEP RS without posterior rectus sheath closure were assessed before and 3 months after surgery using CT scan images. Key measurements analyzed included the distance between linea semilunaris (X2), eccentricity over the Cord (c/a Cord), superior eccentricity (c/a Sup), Y2, and the superior perimeter of the abdomen. The Ellipse 9 tool, which provides graphical images and numerical representations, was utilized alongside patient-reported outcomes to assess perceived abdominal changes.
RESULTS: The study group exhibited a trend toward a flatter abdomen with reduced distance between linea semilunaris(X2). However, 17% of patients developed upper abdominal bulging (5). Significant differences in c/a Cord, c/a Sup, Y2, and the superior perimeter of the abdomen, confirmed with Bonferroni corrections, were noted between bulging (5 patients) and non-bulging groups (25 patients). There was a notable disparity between patient perceptions and objective outcomes.
CONCLUSIONS: The eTEP RS procedure improved abdominal contour in most patients from a selected cohort. The Ellipse 9 tool was valuable for the objective analysis of these changes. The cause of bulging post-eTEP RS is probably multifactorial. Notably, there was often a discrepancy between patient perceptions of bulging and objective clinical findings.
METHODS: Thirty patients undergoing eTEP RS without posterior rectus sheath closure were assessed before and 3 months after surgery using CT scan images. Key measurements analyzed included the distance between linea semilunaris (X2), eccentricity over the Cord (c/a Cord), superior eccentricity (c/a Sup), Y2, and the superior perimeter of the abdomen. The Ellipse 9 tool, which provides graphical images and numerical representations, was utilized alongside patient-reported outcomes to assess perceived abdominal changes.
RESULTS: The study group exhibited a trend toward a flatter abdomen with reduced distance between linea semilunaris(X2). However, 17% of patients developed upper abdominal bulging (5). Significant differences in c/a Cord, c/a Sup, Y2, and the superior perimeter of the abdomen, confirmed with Bonferroni corrections, were noted between bulging (5 patients) and non-bulging groups (25 patients). There was a notable disparity between patient perceptions and objective outcomes.
CONCLUSIONS: The eTEP RS procedure improved abdominal contour in most patients from a selected cohort. The Ellipse 9 tool was valuable for the objective analysis of these changes. The cause of bulging post-eTEP RS is probably multifactorial. Notably, there was often a discrepancy between patient perceptions of bulging and objective clinical findings.
摘要：
背景：eTEPRives-Stoppa（RS）程序，越来越多地用于腹侧疝修补术，引起了人们对术后上腹部膨出的担忧。本研究旨在客观评估eTEPRS后腹部轮廓的变化，并使用一种新颖的分析工具探索潜在的原因。椭圆9
方法：30例接受eTEPRS而没有后直肌鞘闭合的患者在手术前和手术后3个月使用CT扫描图像进行评估。分析的关键测量值包括半毛线之间的距离（X2），电线上的偏心度(c/a电线)，优越的偏心率(c/aSup)，Y2，和腹部的上周长。椭圆9工具，提供图形图像和数字表示，与患者报告的结果一起使用，以评估感知的腹部变化。
结果：研究组表现出腹部平坦的趋势，半月形线（X2）之间的距离减小。然而,17%的患者出现上腹部膨出(5)。C/A线的显著差异，c/aSup,Y2和腹部的上围，通过Bonferroni更正确认，在凸出组（5例患者）和非凸出组（25例患者）之间观察到。患者的看法和客观结果之间存在显著差异。
结论：eTEPRS手术改善了选定队列中大多数患者的腹部轮廓。椭圆9工具对于这些变化的客观分析是有价值的。eTEP后RS膨胀的原因可能是多方面的。值得注意的是,患者对膨胀的看法与客观的临床发现之间通常存在差异。
方法：30例接受eTEPRS而没有后直肌鞘闭合的患者在手术前和手术后3个月使用CT扫描图像进行评估。分析的关键测量值包括半毛线之间的距离（X2），电线上的偏心度(c/a电线)，优越的偏心率(c/aSup)，Y2，和腹部的上周长。椭圆9工具，提供图形图像和数字表示，与患者报告的结果一起使用，以评估感知的腹部变化。
结果：研究组表现出腹部平坦的趋势，半月形线（X2）之间的距离减小。然而,17%的患者出现上腹部膨出(5)。C/A线的显著差异，c/aSup,Y2和腹部的上围，通过Bonferroni更正确认，在凸出组（5例患者）和非凸出组（25例患者）之间观察到。患者的看法和客观结果之间存在显著差异。
结论：eTEPRS手术改善了选定队列中大多数患者的腹部轮廓。椭圆9工具对于这些变化的客观分析是有价值的。eTEP后RS膨胀的原因可能是多方面的。值得注意的是,患者对膨胀的看法与客观的临床发现之间通常存在差异。
