Comparative study of intact specimen extraction in laparoscopic nephrectomy by Pfannenstiel incision.

Autor: Suárez Sal PJ; Servicio de Urología, Hospital Universitario de Cabueñes, Gijón, Spain. Electronic address: p.suarezsal@gmail.com., Fernández-Pello Montes S; Servicio de Urología, Hospital Universitario de Cabueñes, Gijón, Spain., Rúger Jiménez L; Servicio de Urología, Hospital Universitario de Cabueñes, Gijón, Spain., Sánchez Verdes P; Servicio de Urología, Hospital Universitario de Cabueñes, Gijón, Spain., Rodríguez Villamil L; Servicio de Urología, Hospital Universitario de Cabueñes, Gijón, Spain., Fernández Vega I; Servicio de Anatomía Patológica, Hospital Universitario Central de Asturias, Oviedo, Spain; Departamento de Cirugía y Especialidades Médico-Quirúrgicas, Universidad de Oviedo, Oviedo, Spain.
Jazyk: English; Spanish; Castilian
Zdroj: Actas urologicas espanolas [Actas Urol Esp (Engl Ed)] 2023 May; Vol. 47 (4), pp. 229-235. Date of Electronic Publication: 2022 Dec 08.
DOI: 10.1016/j.acuroe.2022.12.001
Abstrakt: Objectives: The aim of our study is to demonstrate that the Pfannenstiel incision is a reliable option in terms of postoperative complications compared to other types of incisions usually performed for kidney extraction after laparoscopic nephrectomy.
Materials and Methods: Retrospective and comparative study of 256 patients who underwent laparoscopic nephrectomy or nephroureterectomy. Patients were divided into two groups: specimen extraction by Pfannenstiel incision (group 1) and specimen extraction by way of other incisions (group 2). Incisional hernia, surgical site infection, pain score, seroma, haematoma/bleeding, wound dehiscence and muscle paralysis were analyzed in each patient.
Results: Patients in Pfannenstiel group presented a rate of wound complications of 11.72% vs. 27.34% with other incisions, p=0.002, it was significantly inferior the rate of wound dehiscence (5.5% vs. 12.5%, p=0.047) and seroma (3.1% vs. 7.8%, p=0.022). Using multivariate logistic regression, Pfannenstiel incision was a significant protective predictor factor for wound complications (OR=0.34, p=0.005).
Conclusions: The Pfannenstiel incision allowed the extraction of bigger kidney masses with less incidence of dehiscence, seroma and in general wound complications. The hospital stay was lower in Pfannenstiel extraction group. These results present this incision as a reliable and safe option in the decision of which incision to select.
(Copyright © 2022 AEU. Published by Elsevier España, S.L.U. All rights reserved.)
Databáze: MEDLINE
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