Histology and Function of the Rectus Abdominis Muscle in Patients With Incisional Hernia

被引:4
作者
Jensen, Kristian K. [1 ]
Oma, Erling [1 ]
Kjaer, Michael [2 ,3 ]
Jorgensen, Lars N. [1 ]
Andersen, Jesper L. [2 ,3 ]
机构
[1] Univ Copenhagen, Digest Dis Ctr, Bispebjerg Hosp, Bispebjerg Bakke 23, DK-2400 Copenhagen NV, Denmark
[2] Univ Copenhagen, Dept Sports Med & Orthoped Surg, Bispebjerg Hosp, Fac Hlth & Med Sci, Copenhagen NV, Denmark
[3] Univ Copenhagen, Ctr Hlth Aging, Fac Hlth & Med Sci, Copenhagen NV, Denmark
关键词
Incisional hernia; Ventral hernia; Computed tomography; Abdominal wall function; Abdominal wall reconstruction; POSTERIOR COMPONENT SEPARATION; QUALITY-OF-LIFE; WALL RECONSTRUCTION; COLONIC-CANCER; ATROPHY; OUTCOMES; MIDLINE; IMPACT;
D O I
10.1016/j.jss.2020.03.033
中图分类号
R61 [外科手术学];
学科分类号
摘要
Background: The aim of the current study was to examine different features of the rectus abdominis muscle (RA) in patients with and without a midline incisional hernia to characterize the effects of a hernia on abdominal wall skeletal muscle. Material and methods: RA tissue from patients undergoing surgical repair of a large midline incisional hernia (n = 18) was compared with that from an intact abdominal wall in patients undergoing colorectal resection for benign or low-grade malignant disease (n = 18). In addition, needle biopsies were obtained from the vastus lateralis muscle (VL) of all subjects. Outcome measures were muscle fiber type and size, preoperative truncal flexion strength and leg extension power measured in strength-measure equipment, and RA cross-sectional area measured by computed tomography. Results: In both the RA and VL, the fiber cross-sectional area was greater in the patients with a hernia. The RA cross-sectional area correlated significantly with the truncal flexion strength (r = 0.44, P = 0.015). Patients in the hernia group had a significantly reduced ratio between truncal flexion strength and RA cross-sectional area compared with the control group (41.3 +/- 11.5 N/cm(2) versus 51.2 +/- 16.3 N/cm(2), P = 0.034). Conclusions: Anatomical displacement of the RA and lack of medial insertion in the linea alba rather than dysfunction secondary to alteration of muscle fiber structure may contribute to impairment of abdominal wall function in patients with midline incisional hernias. (C) 2020 Elsevier Inc. All rights reserved.
引用
收藏
页码:245 / 251
页数:7
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