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Transverse Incision for Pancreatoduodenectomy Reduces Wound Complications: A Single-Center Analysis of 399 Patients

Background: Even if the minimally invasive approach is advancing in pancreatic surgery, the open approach is still the standard for a pancreatoduodenectomy. There are two types of incisions used: the midline incision (MI) and transverse incision (TI). The aim of this study was to compare these two i...

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Autores principales: Junker, Stefanie, Jacobsen, Anne, Merkel, Susanne, Denz, Axel, Krautz, Christian, Weber, Georg F., Grützmann, Robert, Brunner, Maximilian
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10143640/
https://www.ncbi.nlm.nih.gov/pubmed/37109136
http://dx.doi.org/10.3390/jcm12082800
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author Junker, Stefanie
Jacobsen, Anne
Merkel, Susanne
Denz, Axel
Krautz, Christian
Weber, Georg F.
Grützmann, Robert
Brunner, Maximilian
author_facet Junker, Stefanie
Jacobsen, Anne
Merkel, Susanne
Denz, Axel
Krautz, Christian
Weber, Georg F.
Grützmann, Robert
Brunner, Maximilian
author_sort Junker, Stefanie
collection PubMed
description Background: Even if the minimally invasive approach is advancing in pancreatic surgery, the open approach is still the standard for a pancreatoduodenectomy. There are two types of incisions used: the midline incision (MI) and transverse incision (TI). The aim of this study was to compare these two incision types, especially regarding wound complications. Methods: A retrospective review of 399 patients who underwent a pancreatoduodenectomy at the University Hospital Erlangen between 2012 and 2021 was performed. A total of 169 patients with MIs were compared with 230 patients with TIs, with a focus on postoperative fascial dehiscence, postoperative superficial surgical site infection (SSSI) and the occurrence of incisional hernias during follow-up. Results: Postoperative fascial dehiscence, postoperative SSSI and incisional hernias occurred in 3%, 8% and 5% of patients, respectively. Postoperative SSSI and incisional hernias were significantly less frequent in the TI group (SSI: 5% vs. 12%, p = 0.024; incisional hernia: 2% vs. 8%, p = 0.041). A multivariate analysis confirmed the TI type as an independent protective factor for the occurrence of SSSI and incisional hernias (HR 0.45 (95% CI = 0.20–0.99), p = 0.046 and HR 0.18 (95% CI = 0.04–0.92), p = 0.039, respectively). Conclusion: Our data suggest that the transverse incision for pancreatoduodenectomy is associated with reduced wound complications. This finding should be confirmed by a randomized controlled trial.
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spelling pubmed-101436402023-04-29 Transverse Incision for Pancreatoduodenectomy Reduces Wound Complications: A Single-Center Analysis of 399 Patients Junker, Stefanie Jacobsen, Anne Merkel, Susanne Denz, Axel Krautz, Christian Weber, Georg F. Grützmann, Robert Brunner, Maximilian J Clin Med Article Background: Even if the minimally invasive approach is advancing in pancreatic surgery, the open approach is still the standard for a pancreatoduodenectomy. There are two types of incisions used: the midline incision (MI) and transverse incision (TI). The aim of this study was to compare these two incision types, especially regarding wound complications. Methods: A retrospective review of 399 patients who underwent a pancreatoduodenectomy at the University Hospital Erlangen between 2012 and 2021 was performed. A total of 169 patients with MIs were compared with 230 patients with TIs, with a focus on postoperative fascial dehiscence, postoperative superficial surgical site infection (SSSI) and the occurrence of incisional hernias during follow-up. Results: Postoperative fascial dehiscence, postoperative SSSI and incisional hernias occurred in 3%, 8% and 5% of patients, respectively. Postoperative SSSI and incisional hernias were significantly less frequent in the TI group (SSI: 5% vs. 12%, p = 0.024; incisional hernia: 2% vs. 8%, p = 0.041). A multivariate analysis confirmed the TI type as an independent protective factor for the occurrence of SSSI and incisional hernias (HR 0.45 (95% CI = 0.20–0.99), p = 0.046 and HR 0.18 (95% CI = 0.04–0.92), p = 0.039, respectively). Conclusion: Our data suggest that the transverse incision for pancreatoduodenectomy is associated with reduced wound complications. This finding should be confirmed by a randomized controlled trial. MDPI 2023-04-10 /pmc/articles/PMC10143640/ /pubmed/37109136 http://dx.doi.org/10.3390/jcm12082800 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Junker, Stefanie
Jacobsen, Anne
Merkel, Susanne
Denz, Axel
Krautz, Christian
Weber, Georg F.
Grützmann, Robert
Brunner, Maximilian
Transverse Incision for Pancreatoduodenectomy Reduces Wound Complications: A Single-Center Analysis of 399 Patients
title Transverse Incision for Pancreatoduodenectomy Reduces Wound Complications: A Single-Center Analysis of 399 Patients
title_full Transverse Incision for Pancreatoduodenectomy Reduces Wound Complications: A Single-Center Analysis of 399 Patients
title_fullStr Transverse Incision for Pancreatoduodenectomy Reduces Wound Complications: A Single-Center Analysis of 399 Patients
title_full_unstemmed Transverse Incision for Pancreatoduodenectomy Reduces Wound Complications: A Single-Center Analysis of 399 Patients
title_short Transverse Incision for Pancreatoduodenectomy Reduces Wound Complications: A Single-Center Analysis of 399 Patients
title_sort transverse incision for pancreatoduodenectomy reduces wound complications: a single-center analysis of 399 patients
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10143640/
https://www.ncbi.nlm.nih.gov/pubmed/37109136
http://dx.doi.org/10.3390/jcm12082800
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