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International Journal of Colorectal Disease

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01-02-2020 | Incision | Original Article

Left lower transverse incision versus Pfannenstiel-Kerr incision for specimen extraction in laparoscopic sigmoidectomy: a match pair analysis

Authors: N. Varathan, N. Rotigliano, F. Nocera, A. Tampakis, I. Füglistaler, M. von Flüe, D. C. Steinemann, A. Posabella

Published in: International Journal of Colorectal Disease | Issue 2/2020

Abstract

Objective

The ideal location of specimen extraction in laparoscopic-assisted colorectal surgery is still debatable.

Summary

The aim of this study was to compare the incidence of incisional hernias and surgical site infections in patients undergoing elective laparoscopic resection for recurrent sigmoid diverticulitis by performing specimen extraction through left lower transverse incision or Pfannenstiel-Kerr incision.

Methods

A total of 269 patients operated between January 2014 and December 2017 were retrospectively screened for inclusion in the study. Patients with specimen extraction through left lower transverse incision (LLT) and patients with specimen extraction through Pfannenstiel-K incision (P-K) were matched in 1:1 proportion regarding age, sex, comorbidities, and previous abdominal surgery. The incidence of incisional hernias and surgical site infections were compared by using Fisher’s exact test.

Results

After matching 77 patients in the LLT group and 77 patients in the P-K group, they were found to be homogenous regarding the above mentioned descriptive characteristics. No patients in the P-K group developed an incisional hernia compared with 10 patients (13%) in the LLT group (p = 0.001). All these patients required hernia repair with mesh augmentation. The rate of surgical site infections was 1/77 in the P-K group and 0/77 in the LLT group (p = 1.0). In the P-K group, a wound protector was used in 86% of patients whereas in the LLT group, 39% of the wounds were protected during specimen extraction (p < 0.0001).

Conclusion

The Pfannenstiel-Kerr incision may be the preferred extraction site compared with the left lower transverse incision given the significant reduction of the risk of incisional hernias.

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Title: Left lower transverse incision versus Pfannenstiel-Kerr incision for specimen extraction in laparoscopic sigmoidectomy: a match pair analysis
Authors: N. Varathan
N. Rotigliano
F. Nocera
A. Tampakis
I. Füglistaler
M. von Flüe
D. C. Steinemann
A. Posabella
Publication date: 01-02-2020
Publisher: Springer Berlin Heidelberg
Keywords: Incision
Incisional Hernia
Published in: International Journal of Colorectal Disease / Issue 2/2020
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI: https://doi.org/10.1007/s00384-019-03444-6

At a glance: The STEP trials

Springer Medicine

Left lower transverse incision versus Pfannenstiel-Kerr incision for specimen extraction in laparoscopic sigmoidectomy: a match pair analysis

Abstract

Objective

Summary

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Objective

Summary

Methods

Results

Conclusion

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