Yumru Çeliksoy Harika, Cantürk Muhterem Melis, Sözen Hamdullah, Çelik Engin, Baktıroğlu Hatice Merve, Salihoğlu Yavuz, Topuz Samet
Department of Gynecological Oncology, İstanbul University, İstanbul Faculty of Medicine, İstanbul, Turkey
J Turk Ger Gynecol Assoc. 2023 Dec 6;24(4):271-276. doi: 10.4274/jtgga.galenos.2022.2022-3-7. Epub 2022 Dec 30.
The umbilicus is traditionally circumvented while performing a vertical midline abdominal incision. There is a gap in knowledge pertaining to avoiding the umbilicus. Our aim was to investigate whether a transumbilical (TU) or periumbilical (PU) midline incision conferred any advantage to the patient.
This was a retrospective cohort study of patients undergoing ovarian cancer surgery with a midline incision, from the pubic tubercle to the xiphoid. All surgery was performed by the same team of gyneacological oncologists. Patients were classified into two groups according to the midline incision used, TU or PU. The primary endpoint was the incision wound complication rate.
TU and PU midline incisions were performed in 54 and 68 patients, respectively. There were no differences between the two groups in terms of patient characteristics and operative details. The two groups had comparable rates of complications, including wound infection (7.4% vs. 10.3%, p=0.75), deep surgical site infection (11.1% vs. 4.4%, p=0.18), evisceration (3.7% vs. 4.4%, p=0.99) and incisional hernia (33.3% vs. 33.8%, p=0.99).
Our findings suggest that circumventing the umbilicus during laparotomy did not have any advantage. Future prospective randomized trials are warranted to validate this finding.
传统上，在进行腹部正中切口时会避开脐部。在如何避开脐部这方面存在知识空白。我们的目的是研究经脐（TU）或脐周（PU）正中切口是否对患者有任何优势。
这是一项对接受卵巢癌手术且采用从耻骨结节到剑突的正中切口的患者进行的回顾性队列研究。所有手术均由同一组妇科肿瘤学家进行。根据所使用的正中切口将患者分为两组，即TU组或PU组。主要终点是切口伤口并发症发生率。
分别对54例和68例患者进行了TU和PU正中切口手术。两组在患者特征和手术细节方面无差异。两组的并发症发生率相当，包括伤口感染（7.4%对10.3%，p = 0.75）、深部手术部位感染（11.1%对4.4%，p = 0.18）、脏器脱出（3.7%对4.4%，p = 0.99）和切口疝（33.3%对33.8%，p = 0.99）。
我们的研究结果表明，剖腹手术时避开脐部没有任何优势。未来有必要进行前瞻性随机试验来验证这一发现。
