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. 2025 Mar 12;29(1):117.
doi: 10.1007/s10029-025-03303-0.

The sagitta in 3D reconstruction of linea alba on routine CT scans is predictive of postoperative burst abdomen

Matthias Mehdorn  1 , Benedikt Schnarkowski  2 , Sigmar Stelzner  2 , Uwe Scheuermann  2 , Woubet Tefera Kassahun  2 , Timm Denecke  2 , Stefan Niebisch #  2 , Hans-Jonas Meyer #  2
Affiliations

The sagitta in 3D reconstruction of linea alba on routine CT scans is predictive of postoperative burst abdomen

Matthias Mehdorn et al. Hernia. .

Abstract

Purpose: Burst abdomen (BA) is a relevant complication after abdominal surgery that causes additional surgical procedures, prolonged hospital stays and long-term morbidity. Several underlying risk factors exist and have been characterized previously. Those risk factors consist of surgical and medical factors. Recently, CT-derived body composition is of rising interest and 3D reconstruction of the linea alba has been studied. The clinical significance of those parameters is not clear. We therefore performed an analysis of linea alba 3D reconstruction measurements and their prognostic significance on the development of BA.

Methods: An institutional data base of patients with post operative wound infections was assembled. The subgroup of patients with BA was compared to controls. If the patients had complete preoperative abdominal CT scans, their images were further analyzed and 3D reconstruction of the linea alba was performed. Subsequently, lineal alba was measured at predetermined positions. Those values were evaluated as risk factors for postoperative BA.

Results: A total of 72 patients with BA and 32 controls were eligible for the analysis. We found body mass index-related significant differences as well as sex related differences in linea alba width. Furthermore, BA patients had a significantly wider linea alba and longer sagitta compared to controls. In the multivariate analysis of linea alba measurements and clinical parameters, the length of the sagitta was significantly associated with the risk of BA (OR 1.266; 95% CI 1.011-1.585; p = 0.04).

Conclusion: In this study of 3D reconstruction of the linea alba from routine CT scans, we could show that a longer sagitta was associated with an increased risk of postoperative BA.

Keywords: 3D morphometrics; Burst abdomen; Linea alba; Sagitta.

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Conflict of interest statement

Declarations. Ethics approval: The study was approved by the Ethics Review Board of the University of Leipzig under the reference “419/18-ek“ and was retrospectively registered in the German register for clinical trials (DRKS, DRKS00019058, 19th December 2019). Due to the retrospective nature of the study the need for informed consent was waived by the ethics review board. Conflict of interest: None of the authors has any conflict of interest to declare in relation to the presented study or study topic.

Figures

Fig. 1
Fig. 1
Contrast enhanced CT scan in axial (a) and sagittal (b) slices with annotations measuring the linea alba width and the length of linea alba. In (c) we have highlighted the two lines required for the reconstruction and measurements of the sagitta (S; arrowed line.)
Fig. 2
Fig. 2
The receiver of operating characteristics curve of the sagittal diameter to predict burst abdomen. The resulting area under the curve is 0.91 (95%CI 0.87;0.96)
See this image and copyright information in PMC

References

    1. Mehdorn M, Groos L, Kassahun W et al (2021) Interrupted sutures prevent recurrent abdominal fascial dehiscence: a comparative retrospective single center cohort analysis of risk factors of burst abdomen and its recurrence as well as surgical repair techniques. BMC Surg 21(1):208. 10.1186/s12893-021-01219-x - PMC - PubMed
    1. van Ramshorst GH, Nieuwenhuizen J, Hop WC et al (2010) Abdominal wound dehiscence in adults: development and validation of a risk model. World J Surg 34(1):20–27. 10.1007/s00268-009-0277-y - PMC - PubMed
    1. Webster C, Neumayer L, Smout R et al (2003) Prognostic models of abdominal wound dehiscence after laparotomy. J Surg Res 109(2):130–137. 10.1016/s0022-4804(02)00097-5 - PubMed
    1. Gonzalez M, Ruffa T, Scaravonati R et al (2023) Fascial dehiscence: predictable complication? Development and validation of a risk model: a retrospective cohort study. Langenbecks Arch Surg 408(1):50. 10.1007/s00423-023-02782-y - PubMed
    1. Cole J, Hughey S, Metzger A et al (2021) Machine learning to predict fascial dehiscence after exploratory laparotomy surgery. J Surg Res 268:514–520. 10.1016/j.jss.2021.06.068 - PubMed

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