Querleu D, Delahousse G, Turpin D, Leblanc P, Debodinance P, Boutteville C, Meurette J, Laurent J C, Crépin G
Clinique Universitaire de Gynécologie-Obstétrique et de Pathologie de la Reproduction, Roubaix.
Rev Fr Gynecol Obstet. 1987 Nov;82(11):643-8.
The authors report 1,000 cases (357 cesarean sections, 230 hysterectomies for benign lesions, 157 conservative utero-adnexal procedures, 128 tubal plasties, 58 prolapse or incontinence procedures, 70 cancers) ,of laparotomies performed according to the technique described by Mouchel in 1980, i.e. strictly supra-pubic and transverse, from skin to peritoneum, including section of the rectus abdominis. This incision enables to perform in ideal technical conditions, with a minimal complication rate (3 hematomas, 2 incisional hernias for 1,000), and satisfactory esthetic results, almost all of the gynecological and obstetrical surgical procedures (90% of two among the authors' practice). The only contra-indications are, except for cases of previous median laparotomy, ovarian tumors. Neither the high risk of infection, nor obesity, extended hysterectomy, nor fetal distress, represent contra-indications, which is a definite advantage over the Pfannenstiel incision. As compared with the median incision which at some time offered similar results, the esthetics and mainly the strength of the abdominal wall are markedly superior.
作者报告了1000例剖腹手术病例（357例剖宫产、230例因良性病变行子宫切除术、157例保守性子宫附件手术、128例输卵管整形术、58例脱垂或尿失禁手术、70例癌症手术），这些手术均按照1980年穆歇尔描述的技术进行，即严格经耻骨上横向切口，从皮肤到腹膜，包括腹直肌切断。该切口能够在理想的技术条件下进行手术，并发症发生率极低（1000例中有3例血肿、2例切口疝），且美学效果令人满意，几乎能完成所有妇产科手术（占作者手术量的90%）。唯一的禁忌证是既往有正中剖腹手术史的病例以及卵巢肿瘤。感染高风险、肥胖、广泛性子宫切除术、胎儿窘迫均不构成禁忌证，这相对于耻骨联合上横切口而言是一个明显的优势。与曾经能提供类似结果的正中切口相比，该切口的美学效果以及腹壁强度明显更优。
