Umberto Bracale, Cesare Stabilini, Giuseppe Cavallaro, Francesca Pecchini, Gerardo Sarno, Ferdinando Agresta, Michele Carlucci, Simona Rocchetti, Alberto Sartori, Alberto Di Leo, Jacopo Andreuccetti, Giusto Pignata, Ernesto Tartaglia, Carlo Sagnelli, Diego Cuccurullo, Angelo Iossa, Nereo Vettoretto, Ruggiero Lionetti, Camillo Bertoglio, Marco Confalonieri, Mario Testini, Giorgio Soliani, Christian Galatioto, Antonio Crucitti, Micaela Piccoli, Giampaolo Formisano, Biancamaria Iacone, Alberto Aiolfi, Giuseppa Procida, Giulia Montori, Salvatore Tramontano, Andrea Balla, Sara Capoccia Giovannini, Marta Cavalli, Giampiero Campanelli, Mauro Podda
{"title":"意大利关于产后妇女腹直肌转移的诊断和治疗的全国共识会议。","authors":"Umberto Bracale, Cesare Stabilini, Giuseppe Cavallaro, Francesca Pecchini, Gerardo Sarno, Ferdinando Agresta, Michele Carlucci, Simona Rocchetti, Alberto Sartori, Alberto Di Leo, Jacopo Andreuccetti, Giusto Pignata, Ernesto Tartaglia, Carlo Sagnelli, Diego Cuccurullo, Angelo Iossa, Nereo Vettoretto, Ruggiero Lionetti, Camillo Bertoglio, Marco Confalonieri, Mario Testini, Giorgio Soliani, Christian Galatioto, Antonio Crucitti, Micaela Piccoli, Giampaolo Formisano, Biancamaria Iacone, Alberto Aiolfi, Giuseppa Procida, Giulia Montori, Salvatore Tramontano, Andrea Balla, Sara Capoccia Giovannini, Marta Cavalli, Giampiero Campanelli, Mauro Podda","doi":"10.1007/s10029-025-03403-x","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>Rectus Abdominis diastasis (RAD) is a prevalent condition, particularly in post-gravidic women, with functional and esthetic impact. This Delphi consensus, led by general surgeons, aimed to establish evidence-based recommendations for the diagnosis and management of RAD in post-gravidic women.</p><p><strong>Methods: </strong>A Delphi process was conducted under the auspices of the Italian Society of Hernia and Abdominal Wall Surgery (ISHAWS), the national chapter of the European Hernia Society (EHS). A steering committee supervised systematic literature reviews to evaluate the quality of evidence and formulate recommendations. Iterative rounds of voting involving 105 expert panellists were conducted, with Consensus defined as ≥ 70% agreement. Non-consensual recommendations were revised and discussed in a plenary session during the Italian Society of Surgery (SIC) Congress, 2024.</p><p><strong>Results: </strong>Consensus was achieved on 12 recommendations covering RAD diagnosis, classification, and treatment. Key findings included the endorsement of radiological methods for accurate RAD assessment, the establishment of surgical thresholds (> 2.5 cm inter-recti distance for symptom improvement), and the recommendation of minimally invasive linea alba plication for surgical management. Non-operative treatments, such as targeted exercise programs, were emphasized as first-line approaches. For RAD with concomitant hernias of the linea alba with defects > 1 cm, mesh reinforcement was strongly recommended, with extraperitoneal placement preferred. The importance of tailoring approaches based on patient-specific factors and fostering shared decision-making was highlighted.</p><p><strong>Conclusion: </strong>This consensus provides a structured framework for RAD management, emphasizing accurate diagnosis, tailored treatments, and patient-centered care. Future multicenter studies are required to address remaining evidence gaps and refine these recommendations.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"213"},"PeriodicalIF":2.4000,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"The Italian national consensus conference on the diagnosis and treatment of Rectus Abdominis diastasis in Post-gravidic Women.\",\"authors\":\"Umberto Bracale, Cesare Stabilini, Giuseppe Cavallaro, Francesca Pecchini, Gerardo Sarno, Ferdinando Agresta, Michele Carlucci, Simona Rocchetti, Alberto Sartori, Alberto Di Leo, Jacopo Andreuccetti, Giusto Pignata, Ernesto Tartaglia, Carlo Sagnelli, Diego Cuccurullo, Angelo Iossa, Nereo Vettoretto, Ruggiero Lionetti, Camillo Bertoglio, Marco Confalonieri, Mario Testini, Giorgio Soliani, Christian Galatioto, Antonio Crucitti, Micaela Piccoli, Giampaolo Formisano, Biancamaria Iacone, Alberto Aiolfi, Giuseppa Procida, Giulia Montori, Salvatore Tramontano, Andrea Balla, Sara Capoccia Giovannini, Marta Cavalli, Giampiero Campanelli, Mauro Podda\",\"doi\":\"10.1007/s10029-025-03403-x\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>Rectus Abdominis diastasis (RAD) is a prevalent condition, particularly in post-gravidic women, with functional and esthetic impact. This Delphi consensus, led by general surgeons, aimed to establish evidence-based recommendations for the diagnosis and management of RAD in post-gravidic women.</p><p><strong>Methods: </strong>A Delphi process was conducted under the auspices of the Italian Society of Hernia and Abdominal Wall Surgery (ISHAWS), the national chapter of the European Hernia Society (EHS). A steering committee supervised systematic literature reviews to evaluate the quality of evidence and formulate recommendations. Iterative rounds of voting involving 105 expert panellists were conducted, with Consensus defined as ≥ 70% agreement. Non-consensual recommendations were revised and discussed in a plenary session during the Italian Society of Surgery (SIC) Congress, 2024.</p><p><strong>Results: </strong>Consensus was achieved on 12 recommendations covering RAD diagnosis, classification, and treatment. Key findings included the endorsement of radiological methods for accurate RAD assessment, the establishment of surgical thresholds (> 2.5 cm inter-recti distance for symptom improvement), and the recommendation of minimally invasive linea alba plication for surgical management. Non-operative treatments, such as targeted exercise programs, were emphasized as first-line approaches. For RAD with concomitant hernias of the linea alba with defects > 1 cm, mesh reinforcement was strongly recommended, with extraperitoneal placement preferred. The importance of tailoring approaches based on patient-specific factors and fostering shared decision-making was highlighted.</p><p><strong>Conclusion: </strong>This consensus provides a structured framework for RAD management, emphasizing accurate diagnosis, tailored treatments, and patient-centered care. Future multicenter studies are required to address remaining evidence gaps and refine these recommendations.</p>\",\"PeriodicalId\":13168,\"journal\":{\"name\":\"Hernia\",\"volume\":\"29 1\",\"pages\":\"213\"},\"PeriodicalIF\":2.4000,\"publicationDate\":\"2025-06-27\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Hernia\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s10029-025-03403-x\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"SURGERY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Hernia","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s10029-025-03403-x","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"SURGERY","Score":null,"Total":0}
The Italian national consensus conference on the diagnosis and treatment of Rectus Abdominis diastasis in Post-gravidic Women.
Purpose: Rectus Abdominis diastasis (RAD) is a prevalent condition, particularly in post-gravidic women, with functional and esthetic impact. This Delphi consensus, led by general surgeons, aimed to establish evidence-based recommendations for the diagnosis and management of RAD in post-gravidic women.
Methods: A Delphi process was conducted under the auspices of the Italian Society of Hernia and Abdominal Wall Surgery (ISHAWS), the national chapter of the European Hernia Society (EHS). A steering committee supervised systematic literature reviews to evaluate the quality of evidence and formulate recommendations. Iterative rounds of voting involving 105 expert panellists were conducted, with Consensus defined as ≥ 70% agreement. Non-consensual recommendations were revised and discussed in a plenary session during the Italian Society of Surgery (SIC) Congress, 2024.
Results: Consensus was achieved on 12 recommendations covering RAD diagnosis, classification, and treatment. Key findings included the endorsement of radiological methods for accurate RAD assessment, the establishment of surgical thresholds (> 2.5 cm inter-recti distance for symptom improvement), and the recommendation of minimally invasive linea alba plication for surgical management. Non-operative treatments, such as targeted exercise programs, were emphasized as first-line approaches. For RAD with concomitant hernias of the linea alba with defects > 1 cm, mesh reinforcement was strongly recommended, with extraperitoneal placement preferred. The importance of tailoring approaches based on patient-specific factors and fostering shared decision-making was highlighted.
Conclusion: This consensus provides a structured framework for RAD management, emphasizing accurate diagnosis, tailored treatments, and patient-centered care. Future multicenter studies are required to address remaining evidence gaps and refine these recommendations.
期刊介绍：
Hernia was founded in 1997 by Jean P. Chevrel with the purpose of promoting clinical studies and basic research as they apply to groin hernias and the abdominal wall . Since that time, a true revolution in the field of hernia studies has transformed the field from a ”simple” disease to one that is very specialized. While the majority of surgeries for primary inguinal and abdominal wall hernia are performed in hospitals worldwide, complex situations such as multi recurrences, complications, abdominal wall reconstructions and others are being studied and treated in specialist centers. As a result, major institutions and societies are creating specific parameters and criteria to better address the complexities of hernia surgery.
Hernia is a journal written by surgeons who have made abdominal wall surgery their specific field of interest, but we will consider publishing content from any surgeon who wishes to improve the science of this field. The Journal aims to ensure that hernia surgery is safer and easier for surgeons as well as patients, and provides a forum to all surgeons in the exchange of new ideas, results, and important research that is the basis of professional activity.
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