The impact of obesity on the recovery of abdominal wall and possibility of recurrence after incisional hernia repair:A 3D reconstruction-based retrospective study
YANG Rong-duo
LI Shao-chun
MENG Yun-xiao
HUANG Lei
CAI Zhao
TANG Jian-xiong
LI Shao-jie
Abstract：Objective To analyze the impact of obesity on the recovery of the rectus abdominis muscle after mesh repair of incisional hernia via establishing an objective method with computed tomography(CT)scan-based 3D reconstruction technology,and to investigate the mechanism underlying the elevated recurrence rate associated with obesity.Methods A retrospective analysis was conducted on the clinical data from 73 patients with abdominal incisional hernia(maximum defect diameter ≥4 cm)who underwent mesh repair at the Department of General Surgery,Huadong Hospital affiliated to Fudan University between February 2023 and August 2024,and had a postoperative period exceeding 3 months.Patients were stratified into three groups based on BMI:normal group(18.5-＜24.0),overweight group(24.0-＜28.0),and obesity group(≥28.0).Preoperative and postoperative abdominal CT images were reconstructed three-dimensionally using 3D Slicer software(version 5.7.0)to quantify rectus abdominis muscle volume.Results 3D reconstruction imaging of the abdominal wall in incisional hernia patients following mesh repair demonstrated improved morphological uniformity of the abdominal wall and partial anatomical and functional recovery of the rectus abdominis muscle accompanied by a significant volume increase.No statistically significant intergroup differences were observed in absolute preoperative-to-postoperative volume increments of rectus abdominis muscle among the three cohorts(P＞0.05).The normal group exhibited a greater percentage increase in rectus abdominis muscle volume compared to the overweight and obesity groups[(12.1±2.2)％vs.(9.4±1.6)％vs.(7.9±2.0)％)],with statistically significant pairwise differences(t=5.159 and 6.059,P＜0.05).Conclusion The 3D reconstruction indicates that the obesity significantly reduces the recovery ability of the rectus abdominis muscle in patients with incisional hernia after mesh repair,suggesting that obesity-induced impairment of muscle recovery is a potential mechanism for the increased recurrence rate in obese patients.
Keywords：obesityincisional herniarectus abdominis muscle volume3D reconstructionhernia recurrence
Publication Date：2025-04-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：4( 457-460 )