The value of CT diagnosis of hernia recurrence after prosthetic repair of ventral incisional hernias

Abstract.

Herein we present a prospective study made to compare the diagnostic value of a physical examination and a CT scan in the detection of a hernia relapse after carrying out of a intraperitoneal hernioplasty using a non-resorbable mesh. Fifty patients operated on for intraperitoneal hernioplasty with ePTFE mesh and postoperative symptomatology were assessed within a year of the operation via a physical exploration and CT. Each of the patients was subjected to an exploratory laparoscopy for the purpose of confirming the diagnosis. The data were analysed statistically using a chi-square test, sensitivity, specificity, confidence limits, positive predictive value, and negative predictive value. The hernia relapse was correctly diagnosed in 98% of cases by CT and in 88% of cases in the physical examination. The sensitivity was 1 in the CT examination and 0.75 in the physical examination, and the specificity results were 0.97 and 0.90, respectively. The positive predictive value in the CT exam was 0.88, whereas in the physical examination it was 0.60. The negative predictive values were 1 and 0.95, respectively. The differences between the values of both methods held a statistical meaning (chi-square test; p<0.05). The postoperative assessment by CT of symptomatic patients who have been operated on for an intraperitoneal hernioplasty with unabsorbable mesh facilitates carrying out a correct diagnosis in the detection or exclusion of hernial relapse.