Guo Jingjing, Yang Dong, Zhang Bao, Xu Xing, Yang Zhuo, Zhao Yan, Zheng Zhichao, Meng Xiangyu, Zhang Tao
Liaoning University of Traditional Chinese Medicine, China.
Department of Gastric Cancer, Cancer Hospital of Dalian University of Technology (Liaoning Cancer Hospital and Institute), Shenyang, Liaoning, China.
Wideochir Inne Tech Maloinwazyjne. 2024 Mar;19(1):1-10. doi: 10.5114/wiitm.2023.134194. Epub 2023 Dec 29.
The Pfannenstiel incision is often used in gynecological Cesarean section; however, there is limited research on the use of the Pfannenstiel incision for specimen extraction in laparoscopic surgery for the treatment of colorectal cancer.
To evaluate the safety of using the Pfannenstiel incision for specimen extraction in laparoscopic surgery for colorectal cancer patients.
PubMed, Embase, Web of Science, Cochrane Library, CNKI, VIP and WanFangData were searched for studies published up to March 10, 2023; a random-effects model (RCT) and a fixed-effect model were used to evaluate the safety. Operative time, length of extraction skin incision, overall complications, superficial wound infection, organ/space surgical site infection and incisional hernia were evaluated.
A total of 5 studies were included in this research. There were no significant advantages in operation time, length of the incision, overall complications, superficial wound infection and organ/space surgical site in the Pfannenstiel group compared to the no Pfannenstiel group. However, the Pfannenstiel incision has a tendency to increase the length of the incision (SMD = 0.05; 95% CI = -0.22 to 0.33; p = 0.71) and the results of the remaining five (operative time,overall complications,incisional hernia, incisional infection and organ/space surgical site infection) are slightly skewed toward the Pfannenstiel incision. It is worth mentioning that incisional hernia (IH) may have an advantage in the Pfannenstiel group compared to the no Pfannenstiel group. Four studies were not at clear risk of bias and two studies were at risk of bias.
Our study concludes that the Pfannenstiel incision has a good safety record and it is a good option for extracting specimens during laparoscopic surgery for colon cancer. The Pfannenstiel incision used for laparoscopic surgical specimen extraction has a significantly lower incidence of incisional hernia over no Pfannenstiel.
Pfannenstiel切口常用于妇科剖宫产手术；然而，关于Pfannenstiel切口在腹腔镜结直肠癌手术中用于标本取出的研究有限。
评估Pfannenstiel切口在腹腔镜结直肠癌手术中用于标本取出的安全性。
检索PubMed、Embase、Web of Science、Cochrane图书馆、CNKI、维普和万方数据中截至2023年3月10日发表的研究；采用随机效应模型（RCT）和固定效应模型评估安全性。评估手术时间、取出皮肤切口长度、总体并发症、浅表伤口感染、器官/腔隙手术部位感染和切口疝。
本研究共纳入5项研究。与非Pfannenstiel组相比，Pfannenstiel组在手术时间、切口长度、总体并发症、浅表伤口感染和器官/腔隙手术部位方面无显著优势。然而，Pfannenstiel切口有增加切口长度的趋势（标准化均数差=0.05；95%可信区间=-0.22至0.33；p=0.71），其余五项（手术时间、总体并发症、切口疝、切口感染和器官/腔隙手术部位感染）的结果略微倾向于Pfannenstiel切口。值得一提的是，与非Pfannenstiel组相比，Pfannenstiel组在切口疝（IH）方面可能具有优势。四项研究不存在明显的偏倚风险，两项研究存在偏倚风险。
我们的研究得出结论，Pfannenstiel切口具有良好的安全记录，是腹腔镜结肠癌手术中取出标本的良好选择。用于腹腔镜手术标本取出的Pfannenstiel切口与非Pfannenstiel切口相比，切口疝发生率显著降低。
