COMPUTED TOMOGRAPHY IN TREATMENT OF PATIENTS WITH LARGE INCISIONAL HERNIAS
A review of modern publications reflecting the scientific and applied aspects of computed tomography (CT) use at the most important stages of treatment of patients with large incisional hernias is presented. Based on the literature data, the role of this study in the diagnosis of hernias and their recurrence is shown. The importance of CT in planning the forthcoming surgical intervention, the choice of access and the operation technique has been demonstrated. Methods are given for assessing the loss domain phenomenon and choosing the optimal sequence of steps in this situation. Modern approaches and the indications for component separation depending on the width of the hernial orifice, their area and loss domain situation are described. The points of view of various surgical schools and experts on this issue are indicated. The most important aspects of the dynamics of intra-abdominal pressure after abdominal wall reconstruction, depending on the initial CT data, are described, their influence on complications risk, acute respiratory failure, in the postoperative period is noted. The possibilities of CT in the early detection of postoperative complications, including life-threatening ones, have been analyzed. As a result of modern publications review, the necessity of CT inclusion in the algorithm for preparing patients with large incisional hernias for reconstruction of the abdominal wall has been substantiated.