Page 96 - Prevention and Treatment of Incisional Hernia- New Techniques and Materials

Chapter 5
CT scan is reliable and reproducible, whereas ultrasound is more operator-dependant. However, CT scan will induce a radiation load to the patients and ultrasound is more accessible in most health care settings. A good standardisation and dynamic evaluation by ultrasound of the abdominal wall is needed, as described by Beck et al.(51) as the dynamic abdominal sonography for hernia (DASH) technique.
The di erence in accuracy between physical examination and imaging technique is most important in the context of comparative studies evaluating incisional hernia rate. Next to the method of incisional hernia diagnosis the length of follow-up is important. Fink et al.(5) reported in a follow-up study of two prospective trials an increase from 12.6 % at 12 months to 22.4 % at 36 months (p < 0.001) and concluded that follow-up for 3 years should be mandatory in any study evaluating the rate of postoperative incisional hernia after midline laparotomy.
Statement
It is recommended that prospective studies with incisional hernia as a primary outcome integrate medical imaging, either dynamic ultrasound or CT-scan, in the follow-up.
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Statement
It is recommended that studies with incisional hernia as a primary outcome include follow- up of at least 24 months (and preferably 36 months).
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strong
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