Trends in operative treatment of the rectus diastasis A 13 year analysis of German nationwide hospital discharge data
Bibliographic record
Abstract
PURPOSE: The indication for surgical treatment of rectus diastasis (RD) without a coexisting hernia remains controversial. Although guidelines exist, the lack of robust data allows only weak recommendations. This study aimed to provide comprehensive nationwide data on the surgical management of RD without hernia. METHODS: This retrospective observational multicenter study analyzed anonymous data from the German nationwide hospital discharge dataset (2010-2023). Patients with coexisting hernia or under 18 years were excluded. The primary endpoint was the annual number of RD surgeries without hernia. Secondary endpoints included trends over 13 years, patient demographics, mesh use, and early postoperative complications. RESULTS: A total of 2,768 cases were identified (mean age 46.2 ± 13.2 years; 76.2% female). The annual case number ranged from 120 to 253, with no consistent trend. A mesh was used in 28.0% (n = 775), while 72.0% underwent reconstruction without documented mesh. Data on surgical approach (open vs. minimally invasive) were not available. The overall early complication rate was 6.9%, with bleeding and wound infections most common. Male patients had significantly higher complication rates. Major limitations include potential coding bias, underreporting, and missing data on surgical technique. CONCLUSION: This is the first real-world big data analysis of RD repair without hernia in Germany. On average, 198 procedures are performed annually with a low complication rate. The findings support surgical treatment in selected symptomatic cases and emphasize the need for standardized coding and prospective registry data.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".