Literature DB >> 16467983

Optimal abdominal incision for partial hepatectomy: increased late complications with Mercedes-type incisions compared to extended right subcostal incisions.

Michael D'Angelica1, Sridevi Maddineni, Yuman Fong, Robert C G Martin, Michael S Cohen, Leah Ben-Porat, Mithat Gonen, Ronald P DeMatteo, Leslie H Blumgart, William R Jarnagin.   

Abstract

INTRODUCTION: The optimal abdominal incision for partial hepatectomy has not been established.
METHODS: A prospective hepatobiliary surgery database was retrospective reviewed. Patients with Mercedes and extended right subcostal (ERSC) incisions were identified and compared.
RESULTS: Between December 1991 and September 2001 a total of 1426 patients met the inclusion criteria. Among them, 856 (60%) had a Mercedes incision and 570 (40%) an ERSC incision. The two groups were well matched for demographics and operative variables. Perioperative morbidity and pulmonary complications were similar for the two groups as well. There was no difference in terms of early wound complications, although incisional hernias occurred in 9.8% of patients with a Mercedes incision compared to 4.8% of those with an ERSC incision (P = 0.0001). On multivariate analysis, the incision type, along with gender, body mass index, and age, were significant predictors of incisional hernia.
CONCLUSIONS: An ERSC incision for partial hepatectomy provides adequate, safe access and is associated with fewer long-term wound complications.

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Year:  2006        PMID: 16467983     DOI: 10.1007/s00268-005-0183-x

Source DB:  PubMed          Journal:  World J Surg        ISSN: 0364-2313            Impact factor:   3.352


  33 in total

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5.  Surgical site infections: reanalysis of risk factors.

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  13 in total

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2.  Mass Continuous Suture versus Layered Interrupted Suture in Transverse Abdominal Incision Closure after Liver Resection.

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3.  Outcome of and risk factors for incisional hernia after partial hepatectomy.

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6.  Incisional hernia formation in hepatobiliary surgery using transverse and hybrid incisions: a systematic review and meta-analysis.

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Authors:  L Tastaldi; J A Blatnik; D M Krpata; C C Petro; A Fafaj; H Alkhatib; M Svestka; S Rosenblatt; A S Prabhu; M J Rosen
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