Brown S R, Goodfellow P J, Adam I J, Shorthouse A J
Department of Colorectal Surgery, Royal Hallamshire Hospital, Sheffield, UK.
Tech Coloproctol. 2004 Mar;8(1):15-8. doi: 10.1007/s10151-004-0044-x.
A transverse skin crease incision for right hemicolectomy may result in more rapid recovery than traditional vertical midline incision. This hypothesis was tested with a prospective randomised trial.
Patients from 2 centres undergoing right hemicolectomy were randomised to received a midline or transverse incision. Incision lengths were sufficient to enable unrestricted resection of the right colon. Patients and carers were blinded to the incisions using strategically placed dressings. Analgesia and oral intake were controlled by the patient. Operative details and recovery parameters were compared.
A total of 28 patients were randomised. Demographic data and tumour characteristics of the two treatment groups were similar. The transverse incision group had a slightly shorter median wound (10 cm vs. 11 cm, p<0.05). Operative time, analgesia requirements, recovery parameters (time to discharge, 6.5 vs. 6.5 days) and frequency of complications were otherwise comparable.
A transverse skin crease incision for right hemicolectomy results in a slightly smaller wound but no other advantages were demonstrated compared with a traditional vertical midline incision.
右半结肠切除术采用横向皮肤皱襞切口可能比传统的垂直中线切口恢复更快。本假设通过一项前瞻性随机试验进行了验证。
来自2个中心接受右半结肠切除术的患者被随机分配接受中线或横向切口。切口长度足以确保对右结肠进行无限制切除。使用精心放置的敷料使患者和护理人员对切口不知情。镇痛和经口摄入量由患者自行控制。比较手术细节和恢复参数。
共有28例患者被随机分组。两个治疗组的人口统计学数据和肿瘤特征相似。横向切口组的中位伤口略短(10厘米对11厘米,p<0.05)。手术时间、镇痛需求、恢复参数(出院时间,6.5天对6.5天)和并发症发生率在其他方面具有可比性。
右半结肠切除术采用横向皮肤皱襞切口导致的伤口略小,但与传统的垂直中线切口相比未显示出其他优势。