Magnetic resonance imaging in the diagnosis for predictors of ventral hernia recurrence

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Abstract

Introduction: The problem of surgical treatment of patients with ventral hernias remains actual over years. This is due to significant number of patients with this pathology as well as a steadily high percentage of recurrence of the disease after reconstructive operations (24%–44%).

Aim: To identify the interrelation between the constitutional peculiarities of patients and the condition of the anterior abdominal wall tissues as predictors of the formation and recurrence of ventral hernias, based on the results of magnetic-resonance study.

Materials and methods: To assess the connection between the body constitution, the age and the morphological structure of the anterior abdominal wall, we examined 71 patients who were referred for magnetic-resonance examination of the abdominal cavity. In the work, the age of the patients was defined (WHO classification (2015)), and the body mass index. To reveal the signs of undifferentiated connective tissue dysplasia (CTD), the chart by T. Milkovska–Dmitrova and A. Karkashev (1985) was used. For statistical processing of the data and construction of the graph, Statistica 13.3, SPSS 14.0 for Windows Evaluation Version, MS Excel 2016 statistic packages were used.

Results:  Fatty degeneration of muscle tissue (DMT) prevails among elder individuals (rxy=-0.540; p< 0.05). Obesity is accompanied by diastasis of abdominal rectus muscles (rxy=0.806, p< 0.05) and fatty degeneration (rxy=0.568; p< 0.05). Connective tissue dysplasia is closely associated with the rectus muscle diastasis (rxy=0.948; tСт=3.834; p< 0.05) and distension of the umbilical ring (rxy=0.934; T-test=3.703, p< 0.05). Latent aponeurosis defects are also most characteristic of patients with connective tissue dysplasia; however, this dependence was not statistically confirmed in the studied cohort (rxy=0.258; T-test=0.734, p> 0.05).

Conclusion: Вefore planning surgical intervention for ventral hernia, we recommend MRI examination of the anterior abdominal wall tissues be performed in patients for determination of the volume of the intervention to prevent recurrence.

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About the authors

Andrey V. Fedoseev

Ryazan State Medical University

Email: hirurgiarzn@gmail.com
ORCID iD: 0000-0002-6941-1997
SPIN-code: 6522-1989
Scopus Author ID: 7005122675
ResearcherId: S-8606-2016

MD, Dr. Sci. (Med.), Professor

Russian Federation, Ryazan

Vyacheslav S. Shklyar

Ryazan State Medical University

Email: hirurgiarzn@gmail.com
ORCID iD: 0000-0002-7267-4085
SPIN-code: 9683-9598

Postgraduate student of the Department of General Surgery

Russian Federation, Ryazan

Sergey N. Lebedev

Ryazan State Medical University

Email: dguba_dze@mail.ru
ORCID iD: 0000-0002-7139-7100
SPIN-code: 3482-3313
Scopus Author ID: 57209758284
ResearcherId: D-8177-2018

MD, Cand. Sci. (Med.)

Russian Federation, Ryazan

Alexander S. Inyutin

Ryazan State Medical University

Author for correspondence.
Email: aleksandr4007@rambler.ru
ORCID iD: 0000-0001-8812-3248
SPIN-code: 7643-9022
Scopus Author ID: 57195950651
ResearcherId: D-4482-2018

Cand. Sci. (Med.), Associate Professor

Russian Federation, Ryazan

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Supplementary files

Supplementary Files
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1. JATS XML
2. Fig. 1. Alterations in the tissues of the anterior abdominal wall: fatty degeneration of muscles (a); latent defects of the aponeurosis (b).

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3. Fig. 2. Changes in the structure of the abdominal white line: umbilical ring expansion (a); rectus muscle diastasis (b).

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4. Fig. 3. Identified morphological signs and their combination in the examined patients.

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