Abstract：
BACKGROUND: Recurrent ventral hernia repair can be challenging due to scarred tissue planes and the increasing complexity of disease related to multiple recurrences. Given the challenges of acquiring complete and accurate prior operative reports, surgeons often rely on computed tomography (CT) scans to obtain information and plan for re-operation. Still, the contribution of CT scans and the ability of surgeons to interpret them is controversial. Previously, we examined the ability of surgeons to determine prior operative techniques based on CT scans. Here, we assessed the accuracy of expert abdominal wall reconstruction (AWR) surgeons in identifying the type of prior mesh using CT imaging.
METHODS: A total of 22 highly experienced AWR surgeons were asked to evaluate 21 CT scans of patients who had undergone open ventral hernia repair with bilateral transversus abdominis release utilizing mesh. The surgeons were required to identify the mesh type from a multiple-choice selection. Additionally, negative controls (patients without a history of prior laparotomy) and positive controls (patients with laparotomy but no ventral hernia repair) were incorporated. The accuracy of the surgeons and interrater reliability was calculated.
RESULTS: The accuracy rate of the surgeons in correctly identifying the mesh type was 46%, with heavy-weight synthetic mesh (HWSM) being identified only 35.4% of the time, Strattice mesh and medium-weight synthetic mesh (MWSM) were identified at 46.3%, and 51.8%, respectively. The interrater reliability analysis found a moderate level of agreement 0.428 (95% CI 0.356-0.503), and the repeatability measure was poor-0.053 (95% CI 0-0.119); this indicates that surgeons cannot reliably replicate the identification process.
CONCLUSIONS: Surgeons\' ability to accurately identify the type of previous mesh using CT scans is poor. This study underscores the importance of documenting the type of mesh used in the operative report and the need for standardized operative notes to improve the accuracy and consistency of documentation.
METHODS: A total of 22 highly experienced AWR surgeons were asked to evaluate 21 CT scans of patients who had undergone open ventral hernia repair with bilateral transversus abdominis release utilizing mesh. The surgeons were required to identify the mesh type from a multiple-choice selection. Additionally, negative controls (patients without a history of prior laparotomy) and positive controls (patients with laparotomy but no ventral hernia repair) were incorporated. The accuracy of the surgeons and interrater reliability was calculated.
RESULTS: The accuracy rate of the surgeons in correctly identifying the mesh type was 46%, with heavy-weight synthetic mesh (HWSM) being identified only 35.4% of the time, Strattice mesh and medium-weight synthetic mesh (MWSM) were identified at 46.3%, and 51.8%, respectively. The interrater reliability analysis found a moderate level of agreement 0.428 (95% CI 0.356-0.503), and the repeatability measure was poor-0.053 (95% CI 0-0.119); this indicates that surgeons cannot reliably replicate the identification process.
CONCLUSIONS: Surgeons\' ability to accurately identify the type of previous mesh using CT scans is poor. This study underscores the importance of documenting the type of mesh used in the operative report and the need for standardized operative notes to improve the accuracy and consistency of documentation.
摘要：
背景：由于瘢痕化的组织平面以及与多次复发相关的疾病的复杂性增加，复发性腹侧疝修复可能具有挑战性。鉴于获取完整和准确的手术前报告的挑战，外科医生通常依靠计算机断层扫描（CT）来获取信息并计划再次手术。尽管如此，CT扫描的贡献和外科医生的解释能力是有争议的.以前,我们检查了外科医生根据CT扫描确定现有手术技术的能力.这里,我们评估了专家腹壁重建术(AWR)外科医生使用CT成像识别先前网格类型的准确性.
方法：共22名经验丰富的AWR外科医生被要求评估21例患者的CT扫描，这些患者接受了开放式腹侧疝修补术并使用网片进行双侧腹横肌松解术。要求外科医生从多项选择中识别网格类型。此外,纳入阴性对照(无开腹手术史的患者)和阳性对照(有开腹手术但无腹侧疝修补术的患者).计算了外科医生的准确性和评估者间的可靠性。
结果：外科医生正确识别网格类型的准确率为46％，重型合成网(HWSM)只有35.4%的时间被识别，格栅网和中等重量合成网(MWSM)的含量为46.3%，51.8%，分别。评估者间可靠性分析发现，中等程度的一致性为0.428(95%CI0.356-0.503)，重复性测量结果较差-0.053(95%CI0-0.119);这表明外科医生无法可靠地复制鉴定过程.
结论：外科医生使用CT扫描准确识别先前网格类型的能力较差。这项研究强调了记录手术报告中使用的网格类型的重要性，以及需要标准化的手术注释以提高文档的准确性和一致性。
方法：共22名经验丰富的AWR外科医生被要求评估21例患者的CT扫描，这些患者接受了开放式腹侧疝修补术并使用网片进行双侧腹横肌松解术。要求外科医生从多项选择中识别网格类型。此外,纳入阴性对照(无开腹手术史的患者)和阳性对照(有开腹手术但无腹侧疝修补术的患者).计算了外科医生的准确性和评估者间的可靠性。
结果：外科医生正确识别网格类型的准确率为46％，重型合成网(HWSM)只有35.4%的时间被识别，格栅网和中等重量合成网(MWSM)的含量为46.3%，51.8%，分别。评估者间可靠性分析发现，中等程度的一致性为0.428(95%CI0.356-0.503)，重复性测量结果较差-0.053(95%CI0-0.119);这表明外科医生无法可靠地复制鉴定过程.
结论：外科医生使用CT扫描准确识别先前网格类型的能力较差。这项研究强调了记录手术报告中使用的网格类型的重要性，以及需要标准化的手术注释以提高文档的准确性和一致性。
