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The inter-observer reliability is very low at clinical examination of parastomal hernia.

https://arctichealth.org/en/permalink/ahliterature141002
Source
Int J Colorectal Dis. 2011 Jan;26(1):89-95
Publication Type
Article
Date
Jan-2011
Author
Ambatchew Gurmu
Peter Matthiessen
Sven Nilsson
Lars Påhlman
Jörgen Rutegård
Ulf Gunnarsson
Author Affiliation
Department of Surgical Gastroenterology, CLINTEC, Karolinska Institutet, Stockholm, Sweden. ambatchew.gurmu@karolinska.se
Source
Int J Colorectal Dis. 2011 Jan;26(1):89-95
Date
Jan-2011
Language
English
Publication Type
Article
Keywords
Body mass index
Colostomy - adverse effects
Hernia - epidemiology - etiology - radiography
Herniorrhaphy
Humans
Observer Variation
Questionnaires
Sweden - epidemiology
Tomography, X-Ray Computed
Abstract
Parastomal hernia in patients with a permanent colostomy is common. The aim of this study was to evaluate the reliability of the diagnosis based on clinical examination and to compare this examination with the result of a specially designed questionnaire and computerised tomography (CT) scan.
Forty-one patients operated upon with an abdominoperineal resection due to rectal cancer at three hospitals between 1996 and 2002 were included. At minimum of 4 years after the operation, they underwent clinical examination by two or three independent surgeons, answered a colostomy questionnaire and were offered a CT scan of the abdominal wall.
At Hospital I, 17 patients were examined by three surgeons, with inter-observer kappa values between 0.35 and 0.64. At Hospital II, 13 patients were examined by three surgeons, the kappa values ranged between 0.29 and 0.43. At Hospital III, 11 patients were examined by two surgeons, with kappa value of 0.73. The kappa value between CT scan and the colostomy questionnaire was 0.45.
The inter-observer reliability was low, indicating that parastomal hernia is difficult to diagnose by patient history and clinical examination. Some herniae may not be detected by CT scan, and the correlation to patient-reported complaints is low. A more sensitive radiological method to detect parastomal hernia is needed.
PubMed ID
20821218 View in PubMed
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