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Analysis of the abdominal musculo-aponeurotic anatomy in rectus diastasis: comparison of CT scanning and preoperative clinical assessment with direct measurement intraoperatively
Department for Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden and Department of Plastic and Reconstructive Surgery, Karolinska University Hospital, 117 76, Stockholm, Sweden .
Division of Surgery, Department of Clinical Science, Intervention and Technology, CLINTEC, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.
Department of Clinical Sciences Danderyds Hospital, Karolinska Institutet, Stockholm, Sweden .
Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Surgery. Division of Surgery, Department of Clinical Science, Intervention and Technology, CLINTEC, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden .
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2014 (English)In: Hernia, ISSN 1265-4906, E-ISSN 1248-9204, Vol. 18, no 4, 465-471 p.Article in journal (Refereed) Published
Abstract [en]

PURPOSE: To evaluate and compare the consistency of agreement of two methods for measuring abdominal rectus diastasis (ARD), preoperative computed tomography (CT) scanning and preoperative clinical assessment were compared with direct measurement intraoperatively.

METHODS: Fifty-five consecutive patients were retrieved from an ongoing prospective randomised trial comparing two operative techniques for the repair of ARD. All patients underwent a preoperative clinical assessment and CT scan, and the results were compared with intraoperative measurement of the ARD width. Agreement between methods was described with Bland-Altman plots (BA plots) and calculated using Lin's Concordance Correlation Coefficient (CCC).

RESULTS: The median width of the diastasis was 4.0 cm in the upper midline and 3.0 cm in the lower midline for the intraoperative measurement. BA plots showed that measurements on CT and intraoperatively are not in agreement in the lower midline, whereas the agreement was stronger between the clinical and the intraoperative method. The CCC was higher for clinical vs. intraoperative measurement (0.479) than for CT vs. intraoperative measurement (-0.002) in the lower midline, although the agreement was over all low. CT scanning underestimated the width of the ARD when compared to 87 % of preoperative clinical assessments, and 83 % of intraoperative measurements. Preoperative clinical assessment overestimated ARD in 35 % when compared with intraoperative measurements.

CONCLUSION: Clinical assessment prior to surgery provides more accurate information than CT scanning in the assessment of ARD width. CT scanning underestimates ARD width when compared with intraoperative measurement.

Place, publisher, year, edition, pages
Paris: Springer, 2014. Vol. 18, no 4, 465-471 p.
Keyword [en]
Rectus diastasis, Reliability, Clinical assessment, Validity, CT scan, Intraoperative measurement
National Category
Surgery
Identifiers
URN: urn:nbn:se:umu:diva-85413DOI: 10.1007/s10029-014-1221-0PubMedID: 24488508OAI: oai:DiVA.org:umu-85413DiVA: diva2:693297
Conference
Volume 18, Issue 4, pp 465-471
Available from: 2014-02-04 Created: 2014-02-04 Last updated: 2017-12-06Bibliographically approved

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Gunnarsson, UlfStrigård, Karin

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