Use of a Pfannenstiel incision in minimally invasive colorectal cancer surgery is associated with a lower risk of wound complications

S. T. Orcutt, C. J. Balentine, C. L. Marshall, C. N. Robinson, D. A. Anaya, A. Artinyan, S. S. Awad, D. H. Berger, Daniel Albo

Research output: Contribution to journalArticle

31 Citations (Scopus)

Abstract

Background The Pfannenstiel incision, widely used in gynecological surgery, has been reported to be associated with lower rates of wound complications than midline incisions in open surgery. However, its effect on wound complications in minimally invasive surgery (MIS) is not well understood. We hypothesize that use of a Pfannenstiel incision in MIS colorectal cancer resections would be associated with fewer short-term wound complication rates. Methods A retrospective cohort study was performed on 171 patients who had undergone MIS colorectal cancer surgery requiring a specimen extraction/hand-access site, divided into a Pfannenstiel and a midline group depending on the type of incision used. Wound complications compared included disruption, infection, dehiscence, evisceration, and fistula formation. The Mann-Whitney U and Fisher's exact tests were used to analyze differences in risk factors between the groups. Logistic regression was performed to determine factors associated with prevention of wound complications. Results Patients in the Pfannenstiel group had significantly lower rates of wound disruption (0 vs. 13%, p = 0.02), superficial surgical site infection (7 vs. 22%, p = 0.03), and overall wound complications (13 vs. 30%, p = 0.04). Using multivariate logistic regression, Pfannenstiel incisions and colon rather than rectal resections were significant predictors of prevention of wound complications. Conclusions The use of a Pfannenstiel incision in MIS colorectal cancer resections is associated with a decreased risk of short-term wound complications.

Original languageEnglish (US)
Pages (from-to)127-132
Number of pages6
JournalTechniques in Coloproctology
Volume16
Issue number2
DOIs
StatePublished - Apr 1 2012
Externally publishedYes

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Colorectal Surgery
Colorectal Neoplasms
Wounds and Injuries
Minimally Invasive Surgical Procedures
Logistic Models
Surgical Wound Infection
Gynecologic Surgical Procedures
Fistula
Colon
Cohort Studies
Retrospective Studies
Hand

Keywords

  • Colorectal cancer
  • Minimally invasive
  • Pfannenstiel
  • Wound complications

ASJC Scopus subject areas

  • Surgery
  • Gastroenterology

Cite this

Use of a Pfannenstiel incision in minimally invasive colorectal cancer surgery is associated with a lower risk of wound complications. / Orcutt, S. T.; Balentine, C. J.; Marshall, C. L.; Robinson, C. N.; Anaya, D. A.; Artinyan, A.; Awad, S. S.; Berger, D. H.; Albo, Daniel.

In: Techniques in Coloproctology, Vol. 16, No. 2, 01.04.2012, p. 127-132.

Research output: Contribution to journalArticle

Orcutt, S. T. ; Balentine, C. J. ; Marshall, C. L. ; Robinson, C. N. ; Anaya, D. A. ; Artinyan, A. ; Awad, S. S. ; Berger, D. H. ; Albo, Daniel. / Use of a Pfannenstiel incision in minimally invasive colorectal cancer surgery is associated with a lower risk of wound complications. In: Techniques in Coloproctology. 2012 ; Vol. 16, No. 2. pp. 127-132.
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AU - Marshall, C. L.

AU - Robinson, C. N.

AU - Anaya, D. A.

AU - Artinyan, A.

AU - Awad, S. S.

AU - Berger, D. H.

AU - Albo, Daniel

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N2 - Background The Pfannenstiel incision, widely used in gynecological surgery, has been reported to be associated with lower rates of wound complications than midline incisions in open surgery. However, its effect on wound complications in minimally invasive surgery (MIS) is not well understood. We hypothesize that use of a Pfannenstiel incision in MIS colorectal cancer resections would be associated with fewer short-term wound complication rates. Methods A retrospective cohort study was performed on 171 patients who had undergone MIS colorectal cancer surgery requiring a specimen extraction/hand-access site, divided into a Pfannenstiel and a midline group depending on the type of incision used. Wound complications compared included disruption, infection, dehiscence, evisceration, and fistula formation. The Mann-Whitney U and Fisher's exact tests were used to analyze differences in risk factors between the groups. Logistic regression was performed to determine factors associated with prevention of wound complications. Results Patients in the Pfannenstiel group had significantly lower rates of wound disruption (0 vs. 13%, p = 0.02), superficial surgical site infection (7 vs. 22%, p = 0.03), and overall wound complications (13 vs. 30%, p = 0.04). Using multivariate logistic regression, Pfannenstiel incisions and colon rather than rectal resections were significant predictors of prevention of wound complications. Conclusions The use of a Pfannenstiel incision in MIS colorectal cancer resections is associated with a decreased risk of short-term wound complications.

AB - Background The Pfannenstiel incision, widely used in gynecological surgery, has been reported to be associated with lower rates of wound complications than midline incisions in open surgery. However, its effect on wound complications in minimally invasive surgery (MIS) is not well understood. We hypothesize that use of a Pfannenstiel incision in MIS colorectal cancer resections would be associated with fewer short-term wound complication rates. Methods A retrospective cohort study was performed on 171 patients who had undergone MIS colorectal cancer surgery requiring a specimen extraction/hand-access site, divided into a Pfannenstiel and a midline group depending on the type of incision used. Wound complications compared included disruption, infection, dehiscence, evisceration, and fistula formation. The Mann-Whitney U and Fisher's exact tests were used to analyze differences in risk factors between the groups. Logistic regression was performed to determine factors associated with prevention of wound complications. Results Patients in the Pfannenstiel group had significantly lower rates of wound disruption (0 vs. 13%, p = 0.02), superficial surgical site infection (7 vs. 22%, p = 0.03), and overall wound complications (13 vs. 30%, p = 0.04). Using multivariate logistic regression, Pfannenstiel incisions and colon rather than rectal resections were significant predictors of prevention of wound complications. Conclusions The use of a Pfannenstiel incision in MIS colorectal cancer resections is associated with a decreased risk of short-term wound complications.

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