Citation Information :
Goyal S, Sharma BK, Misra MC. Study the Sensitivity and Positive Predictive Value of Clinical Finding, Ultrasonography, and Computed Tomography Finding to Detect the Defect Size and Number of Incisional/Ventral Hernia. J Mahatma Gandhi Univ Med Sci Tech 2018; 3 (3):88-92.
Despite the importance of defect size, there are no standardized recommendations on how to measure ventral hernias. Our aims were to determine1 if any significant differences existed between various methods of measuring ventral hernias and2 the effect of these methods of measurement on selection of mesh size. Materials and methods: A prospective study of all patients enrolled in a randomized trial assessing ventral hernia repair at our institution from January 2018 to June 2019 was eligible for inclusion. Abdominal wall hernia defect size will be obtained using the following methods: clinical examination, ultrasonography (USG), and computed tomography (CT) finding. Clinically, measurement will be determined by feeling the edges of muscle and measuring the defect using the measuring tape or thread. Computed tomography abdomen/USG abdomen was done to every patient to confirm the size of defect and its contents of hernia and other associated hernia for estimating the size of the prosthesis to be used. Then, defect size and number of incisional/ventral hernia will be measured intraoperatively using the measuring tape or thread, and this measurement will be compared with the earlier three findings of clinical examination, USG, and CT findings. Results: Thirty patients met inclusion criteria for assessment. Defect size measured by clinical examination in comparison with intraoperative finding of defect size is found out to be statistically significant with a mean value (5.10) more than that of the intraoperative finding (4.85), and p value is <0.05, i.e., 0.012, and defect size measured by USG in comparison with intraoperative finding of defect size is also found out to be statistically significant with a mean value (3.87) less than that of the intraoperative finding (4.85), and p value is <0.05, i.e., 0.036. But the size of defect of hernia measured by CT scan is almost same as that of hernia measured during intraoperative finding with a mean value of 4.60 and 4.85, respectively. Conclusion: Among the three methods of measuring ventral hernia defect, CT scan is most sensitive in detecting the number of hernia and measuring the size of defect followed by clinical examination. Although our study has some limitations due to which we can make no recommendations regarding the ideal measurement method right now. Further studies are needed to determine which method results in optimally sized abdominal wall prostheses and superior ventral hernia repair.
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