Department of Surgery, McGovern Medical School at the University of Texas Health Science Center Houston, Houston, Texas; Center for Surgical Trials and Evidence-Based Practice, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston, Texas.
Department of Surgery, McGovern Medical School at the University of Texas Health Science Center Houston, Houston, Texas; Center for Surgical Trials and Evidence-Based Practice, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston, Texas.
J Surg Res. 2020 Sep;253:121-126. doi: 10.1016/j.jss.2020.03.039. Epub 2020 Apr 27.
With the widespread use of advanced imaging there is a need to quantify the prevalence and impact of hernias. We aimed to determine the prevalence of abdominal wall hernias among patients undergoing computed tomography (CT) scans and their impact on abdominal wall quality of life (AW-QOL).
Patients undergoing elective CT abdomen/pelvis scans were enrolled. Standardized physical examinations were performed by surgeons blinded to the CT scan results. AW-QOL was measured through the modified Activities Assessment Scale. On this scale, 1 is poor AW-QOL, 100 is perfect, and a change of 7 is the minimum clinically important difference. Three surgeons reviewed the CT scans for the presence of ventral or groin hernias. The number of patients and the median AW-QOL scores were determined for three groups: no hernia, hernias only seen on imaging (occult hernias), and clinically apparent hernias.
A total of 246 patients were enrolled. Physical examination detected 62 (25.2%) patients with a hernia while CT scan revealed 107 (43.5%) with occult hernias. The median (interquartile range) AW-QOL of patients per group was no hernia = 84 (46), occult hernia = 77 (57), and clinically apparent hernia = 62 (55).
One-fourth of individuals undergoing CT abdomen/pelvis scans have a clinical hernia, whereas nearly half have an occult hernia. Compared with individuals with no hernias, patients with clinically apparent or occult hernias have a lower AW-QOL (by 22 and seven points, respectively). Further studies are needed to determine natural history of AW-QOL and best treatment strategies for patients with occult hernias.
随着先进成像技术的广泛应用，需要量化疝的患病率和影响。我们旨在确定接受计算机断层扫描 (CT) 扫描的患者腹壁疝的患病率及其对腹壁生活质量 (AW-QOL) 的影响。
招募接受选择性 CT 腹部/骨盆扫描的患者。外科医生对 CT 扫描结果进行了标准化的体格检查。AW-QOL 通过改良活动评估量表进行测量。在此量表上，1 表示 AW-QOL 较差，100 表示 AW-QOL 完美，7 表示最小临床重要差异。三位外科医生审查了 CT 扫描以确定是否存在腹侧或腹股沟疝。确定了无疝、仅在影像学上看到的疝 (隐匿疝) 和临床上明显的疝这三组患者的数量和中位数 AW-QOL 评分。
共纳入 246 例患者。体格检查发现 62 例 (25.2%) 患者有疝，而 CT 扫描显示 107 例 (43.5%) 患者有隐匿疝。每组患者的 AW-QOL 中位数 (四分位距) 分别为无疝=84 (46)、隐匿疝=77 (57)和临床明显疝=62 (55)。
四分之一接受 CT 腹部/骨盆扫描的患者有临床疝，而近一半患者有隐匿疝。与无疝患者相比，有临床明显或隐匿疝的患者的 AW-QOL 较低 (分别低 22 分和 7 分)。需要进一步研究来确定 AW-QOL 的自然病史以及隐匿疝患者的最佳治疗策略。
