98 - Freie Mitteilung
17. Mai 2019, 14:15 - 15:45, Kursaal Arena, 5. OG
Left lower transverse incision versus Pfannenstiel-Kerr incision for laparoscopic specimen extraction in patients with recurrent sigmoid diverticulitis: A comparative study of two surgical techniques
N. Varathan, N. Rotigliano, D.C. Steinemann, I. Füglistaler, M. Von Flüe, A. Posabella, Presenter: N. Varathan (Basel)
The aim of this study is to compare the incidence of incisional hernias and wound infections in patients that underwent an elective laparoscopic resection for recurrent sigmoid diverticulitis with specimen extraction through a left lower transverse incision or a Pfannenstiel-Kerr incision.
Two hundred sixty-nine patients underwent elective laparoscopic sigmoidectomy between January 2014 and December 2017. Of those patients with specimen extraction through a left lower transverse incision (LLT) and patients with specimen extraction through a Pfannenstiel-K incision (P-K) were matched 1:1 controlling for age, sex, comorbidities, and previous abdominal surgery. The baseline data and the results were compared using Fisher’s exact test. Minimum follow-up was 12 months.
After matching, 77 patients in the LLT group and 77 patients in the P-K group were found to be equivalent regarding above mentioned clinical-demographic characteristics. No patients in the P-K group developped an incisional hernia compared to 10 patients (13%) in LLT group (p=0.0014). All of these patients needed hernia repair with a mesh implantation. In the P-K group the wound was protected using an Alexis ® wound protector in 65%, V-drape ® in 14%, or not protected in 21%. In the LLT group the wound was protected using an Alexis® wound protector in 14%, V-drape® in 22%, or not protected in 64%. The rate of wound infections was 1/77 in the P-K group and 0/77 in the LLT group (p=1.0).
The Pfannestiel-Kerr incision may be the preferred extraction site compared to the left lower transverse incision given the significant reduction of the risk of incisional hernias. No difference was shown in the incidence of wound infections, regardless of the use of an intraoperative wound protector.