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Current Women`s Health Reviews

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ISSN (Print): 1573-4048
ISSN (Online): 1875-6581

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Research Article

A Relook into Visceral Slide Test as a Preoperative Screening Modality to Detect Abdominal Wall Adhesions: A Prospective Observational Cohort Study

Author(s): Himanshi Jain, Roopa P. Shivananda*, Shubha Rao, Nivedita Hegde, Sangamithra Paladugu and Akhila Vasudeva

Volume 18, Issue 3, 2022

Published on: 05 August, 2021

Article ID: e031121195330 Pages: 6

DOI: 10.2174/1573404817666210805155219

Price: $65

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Abstract

Background: Ultrasound has become an invaluable tool in our daily practice. Its role in screening for adhesions has been tested since the 1990s.

Objective: This study aims to determine the role of the visceral slide test as a screening method to predict abdominal wall adhesions in women undergoing gynecological surgery.

Methods: We conducted a prospective observational cohort study from August 2017 to July 2019 in women undergoing elective abdominopelvic surgery for a gynecological indication. Preoperatively, a visceral slide test was performed in 5 specified zones on the abdomen and the test results were clinically correlated with the presence, severity, and extent of adhesions intra-operatively.

Results: Results were reported as mean, standard deviation, range of values or number and percent. Sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy (including 95% confidence interval for all) of visceral slide test were calculated to determine intra- abdominal adhesions . We also found a correlation between the number of negative slide tests and PAI scores using Spearman’s correlation test. Of the 339 women who completed the study, 41.2% had a previous history of abdominopelvic surgery. In this study, the visceral slide test was found to have a sensitivity of 70.87% (95%CI 62.15-78.59), specificity of 86.32% (95% CI 80.95-90.64), Positive Predictive Value (PPV) of 75.63% (95% CI 68.49-81.59), negative predictive value (NPV) of 83.18%(95% CI 78.95-86.70) and diagnostic accuracy of 80.53%(95% CI 75.91-84.61)with p-value less than 0.001. The number of negative slide tests positively correlated with the Peritoneal Adhesion Index score (r = 0.662, p < 0.001) and also with increasing operative time and intraoperative blood loss. Accuracy and positive predictive value of the test were significantly higher in patients with a history of abdominal surgeries, endometriosis and PID.

Conclusion: Visceral slide test is an easy, rapid, non-invasive and reliable screening test to predict abdominal adhesions in women undergoing gynecological surgery. The presence of risk factors for adhesions increases the accuracy of the test.

Keywords: Transabdominal ultrasound, visceral slide test, abdominal wall adhesions, gynecologic surgery, accuracy, adhesions result.

Graphical Abstract

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