Luijendijk R W, Jeekel J, Storm R K, Schutte P J, Hop W C, Drogendijk A C, Huikeshoven F J
Department of General Surgery, Leyenburg Hospital, The Hague, The Netherlands.
Ann Surg. 1997 Apr;225(4):365-9. doi: 10.1097/00000658-199704000-00004.
The authors determined the prevalence of incisional hernia and nerve entrapment in patients with a low transverse Pfannenstiel incision.
The literature on the Pfannenstiel incision suggests an incisional hernia rate of 0.0% to 0.5%. However, in these series, physical examination, which is essential in the authors' view, was not performed. To the authors' knowledge, the prevalence of nerve entrapment after the Pfannenstiel incision is not known or has never been published.
All adult women, operated on between 1986 and 1992 using a Pfannenstiel incision and not having had another lower abdominal incision other than for laparoscopy, were invited for follow-up at the outpatient department. All patients were interviewed and subjected to a physical examination, with special interest to the presence of incisional hernia or nerve entrapment.
In patients having had a Pfannenstiel incision, no incisional hernias were found. In patients also having had a laparoscopy, the incisional hernia rate was 3.5%. Nerve entrapment was found in 3.7%. The length of the incision was identified as a risk factor (p = 0.02).
Incisional hernia is a rare complication of the Pfannenstiel incision. Complications of nerve damage, however, are not uncommon and should be recognized. When possible, nerves should be identified and preserved, especially when extending the incision more laterally.
作者确定低位横切口Pfannenstiel切口患者切口疝和神经卡压的发生率。
关于Pfannenstiel切口的文献表明切口疝发生率为0.0%至0.5%。然而，在这些系列研究中，作者认为至关重要的体格检查并未进行。据作者所知，Pfannenstiel切口后神经卡压的发生率尚不清楚或从未发表过。
邀请所有在1986年至1992年间接受Pfannenstiel切口手术且除腹腔镜手术外未进行过其他下腹部切口手术的成年女性到门诊进行随访。对所有患者进行访谈并进行体格检查，特别关注切口疝或神经卡压的情况。
接受Pfannenstiel切口手术的患者未发现切口疝。同时接受过腹腔镜手术的患者，切口疝发生率为3.5%。发现神经卡压的发生率为3.7%。切口长度被确定为一个危险因素（p = 0.02）。
切口疝是Pfannenstiel切口罕见的并发症。然而，神经损伤并发症并不少见，应予以认识。尽可能识别并保留神经，尤其是在切口向外侧延长时。
