Lee Jun Suh, Hong Tae Ho, Kim Jun Gi
Department of Surgery, Armed Forces Capital Hospital, Seongnam, Korea.
J Korean Surg Soc. 2012 Dec;83(6):360-6. doi: 10.4174/jkss.2012.83.6.360. Epub 2012 Nov 27.
The intraumbilical incision is being used more frequently, with increasing cases of single incision laparoscopic surgery. Since the umbilicus is deeper than the surrounding wall, it has abundant bacteria. No study has compared the adverse outcomes of periumbilical and intraumbilical incisions. We analyzed the wound complication rates of perforated appendicitis patients according to the types of umbilical incision.
A retrospective review was done of 280 patients with perforated appendicitis. One hundred fifty nine patients were treated with the intraumbilical incision, and 121 patients were treated with the periumbilical incision. We compared the perioperative outcomes according to each laparoscopic incision.
There was no difference in operation time, postoperative hospital stay and analgesic requirement between the two groups. One case in the intraumbilical group (0.6%) and three cases in the periumbilical group (2.5%) developed wound infections. The umbilical complication rate showed no difference.
The wound complication rate of intraumbilical and periumbilical incisions are not different. Although this retrospective study has inherent limitations, the intraumbilical incision seems to be a safe and feasible alternative for the periumbilical incision that can be easier to perform, with better cosmetic results.
随着单切口腹腔镜手术病例的增加，脐内切口的使用越来越频繁。由于脐部比周围腹壁更深，其细菌含量丰富。尚无研究比较脐周切口和脐内切口的不良结局。我们根据脐部切口类型分析了穿孔性阑尾炎患者的伤口并发症发生率。
对280例穿孔性阑尾炎患者进行回顾性研究。159例患者采用脐内切口治疗，121例患者采用脐周切口治疗。我们根据每种腹腔镜切口比较围手术期结局。
两组患者的手术时间、术后住院时间和镇痛需求无差异。脐内组有1例（0.6%）发生伤口感染，脐周组有3例（2.5%）发生伤口感染。脐部并发症发生率无差异。
脐内切口和脐周切口的伤口并发症发生率无差异。尽管这项回顾性研究存在固有局限性，但脐内切口似乎是脐周切口一种安全可行的替代方法，操作更容易，美容效果更好。
