Rodrigues Bruno de Lima, de Oliveira Marcelo Gonçalves, Garcia Diego Paim Carvalho, Soares Gustavo, Senna Bruna Flávia Cesario, Lima Henrique Araújo, Martins Fabiana Paiva, Faria Eliney Ferreira
Faculdade de Ciências Médicas de Minas Gerais - FCMMG, Faculdade de Medicina, FELUMA - Lucas Machado Educational Foundation, Belo Horizonte, Minas Gerais, Brazil.
MATER DEI Hospital, Belo Horizonte, Minas Gerais, Brazil.
Hernia. 2025 Aug 29;29(1):266. doi: 10.1007/s10029-025-03440-6.
Ventral hernias are a surgical challenge, often requiring detailed imaging for surgical planning. Computed tomography (CT) is widely used in preoperative assessment, with three-dimensional (3D) reconstructions increasingly applied in surgical fields. This study aims to assess whether 3D CT reconstructions improve surgical planning compared to conventional two-dimensional (2D) CT.
A cross-sectional survey was conducted from October 2024 to January 2025, enrolling 66 surgeons with diverse experience. Participants were randomized into two groups: one assessing a complex ventral hernia using conventional CT and the other using both 2D and 3D reconstructions. Data were collected through questionnaires based on the DECOMP criteria, surgeons' perception of hernia characteristics, surgical planning, and treatment strategies. Statistical analyses, including Fisher's exact test, Chi-square test, and ROC curve analysis, were performed to compare outcomes.
No significant differences were found between the groups in the evaluation of the hernia, preoperative planning, or surgical approach. Surgeons predominantly relied on personal interpretation of CT scans rather than radiology reports. Notably, 3D reconstructions decreased the perception of hernia sac omental content (74.2% vs. 97.1%, p = 0.01). Furthermore, 3D visualization did not alter surgical decisions, including mesh selection, component separation, or preoperative techniques for loss of domain.
3D CT reconstructions do not impact the evaluation or surgical planning of complex ventral hernias compared to 2D CT. Although 3D imaging may enhance anatomical visualization, its clinical utility is unclear. Conventional 2D CT, when carefully analyzed, remains sufficient for surgical decision-making. Further research is needed to assess 3D imaging's benefits.
腹疝是一项外科挑战，通常需要详细的影像学检查来进行手术规划。计算机断层扫描（CT）广泛用于术前评估，三维（3D）重建在外科领域的应用越来越多。本研究旨在评估与传统二维（2D）CT相比，3D CT重建是否能改善手术规划。
于2024年10月至2025年1月进行了一项横断面调查，招募了66名经验各异的外科医生。参与者被随机分为两组：一组使用传统CT评估复杂腹疝，另一组使用2D和3D重建。通过基于DECOMP标准的问卷收集数据，包括外科医生对疝特征的认知、手术规划和治疗策略。进行了包括Fisher精确检验、卡方检验和ROC曲线分析在内的统计分析以比较结果。
两组在疝的评估、术前规划或手术方法方面未发现显著差异。外科医生主要依靠对CT扫描的个人解读而非放射学报告。值得注意的是，3D重建降低了对疝囊网膜内容物的认知（74.2%对97.1%，p = 0.01）。此外，3D可视化并未改变手术决策，包括补片选择、组织分离或针对腹腔容积丧失的术前技术。
与2D CT相比，3D CT重建对复杂腹疝的评估或手术规划没有影响。尽管3D成像可能增强解剖可视化，但其临床效用尚不清楚。仔细分析时，传统2D CT仍足以用于手术决策。需要进一步研究来评估3D成像的益处。
