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World Journal of Surgery
Published in: World Journal of Surgery 6/2021

01-06-2021 | Incision | Original Scientific Report

Impact of Abdominal Incision Type on Postoperative Pain and Quality of Life Following Hepatectomy

Authors: Genki Watanabe, Takeaki Ishizawa, Satoshi Yamamoto, Takashi Kokudo, Yujiro Nishioka, Akihiko Ichida, Nobuhisa Akamatsu, Junichi Kaneko, Junichi Arita, Kiyoshi Hasegawa

Published in: World Journal of Surgery | Issue 6/2021

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Abstract

Background

The aim of this prospective study was to analyze the impact of abdominal incision type on postoperative pain and quality of life (QOL) in hepatectomy.

Methods

In patients undergoing hepatectomy by open, hybrid, or pure laparoscopic approaches, we classified abdominal incisions as: pure laparoscopic (LAP), midline (MID), J-shaped (J), and J-shaped incision plus thoracotomy (TRC). Postoperative pain was measured on postoperative day (POD) 3, 7, 30, and 90 using a visual analog scale (VAS). QOL was evaluated using the short-form-36 questionnaire preoperatively and on POD 30 and 90.

Results

We categorized 165 patients into LAP (n = 9, 5%), MID (n = 21, 13%), J (n = 95, 58%), and TRC (n = 40, 24%) groups. Median VAS scores on PODs 3/7/30/90 were: LAP, 27.5/7.5/10/10; MID, 30/10/15/5; J, 50/27.5/20/10, and TRC, 50/30/30/19. The J and TRC groups had significantly higher VAS scores vs. MID on PODs 3 and 7; the LAP and MID groups did not differ significantly. No significant positive correlations were observed between incision length and postoperative VAS, when we stratified patients into two groups according to the presence or absence of a transverse incision. Physical QOL summary scores did not return to preoperative levels even on POD 90, in patients with an additional transverse incision. Mental QOL summary scores worsened with postoperative complications rather than with abdominal incision type.

Conclusions

Transverse incisions, rather than incision length, led to worse midline incision pain and poorer QOL recovery post-hepatectomy. A hybrid approach may be a considerable option when pure laparoscopic hepatectomy is technically difficult.

Trial registration

This study was registered in the UMIN Clinical Trials Registry (registration number: UMIN000017467; http://​www.​umin.​ac.​jp/​ctr/​index.​htm)
Appendix
Available only for authorised users
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Metadata
Title
Impact of Abdominal Incision Type on Postoperative Pain and Quality of Life Following Hepatectomy
Authors
Genki Watanabe
Takeaki Ishizawa
Satoshi Yamamoto
Takashi Kokudo
Yujiro Nishioka
Akihiko Ichida
Nobuhisa Akamatsu
Junichi Kaneko
Junichi Arita
Kiyoshi Hasegawa
Publication date
01-06-2021
Publisher
Springer International Publishing
Published in
World Journal of Surgery / Issue 6/2021
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-021-05992-x

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