Observational studyHernia : the journal of hernias and abdominal wall surgery2026
Postoperative abdominal bulging after eTEP rives-stoppa repair despite posterior rectus sheath closure: a CT-based ellipse 9 study.
Observational study in Hernia : the journal of hernias and abdominal wall surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposePostoperative bulging has been reported after enhanced-view totally extraperitoneal (eTEP) repair, but its underlying mechanisms remain unclear. This study aimed to objectively evaluate postoperative abdominal wall contour changes after eTEP repair with systematic posterior rectus sheath (PRS) closure and to identify factors associated with postoperative bulging using the Ellipse 9 tool.
methodsA retrospective observational study was conducted including patients who underwent eTEP repair with systematic posterior rectus sheath closure for midline hernias with rectus diastasis between 2019 and 2024 and had available preoperative and postoperative computed tomography scans. Abdominal morphometric parameters were analyzed using the Ellipse 9 tool at standardized anatomical levels. Rectus muscle density was assessed. Patients were classified into bulging and non-bulging groups. Preoperative and postoperative measurements were compared within and between groups.
resultsThirty-three patients were included: 24 patients (73%) did not develop postoperative bulging (non-bulging group), whereas 9 patients (27%) developed bulging (bulging group). In the overall cohort, a significant bilateral reduction in rectus muscle density was observed (p<0.001), with no relevant modifications in global abdominal contour. The non-bulging group showed decreased muscle density (right: p=0.036; left: p=0.012) without significant geometric contour changes. In contrast, the bulging group demonstrated significant increases in abdominal dimensions (p≤0.002) and greater reductions in eccentricity (p<0.001), indicating a rounder contour, along with a predominant reduction in right-sided rectus muscle density (p=0.036).
conclusionPostoperative bulging may occur despite systematic PRS closure, supporting a multifactorial origin. Rectus atrophy was insufficient as a sole mechanism, suggesting additional contributions from surgical and functional factors. Structured rehabilitation may improve postoperative outcomes.
Indexed as
Identifiers
42334631What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.