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Suprapubic Cholecystectomy Improves Cosmetic Outcome Compared to Classic Cholecystectomy

Currently, cholecystectomy is performed laparoscopically. While the conventional approach (CA) with four access ports persists, other methods seek to reduce trauma or to optimize cosmetic results. In this study, the safety and cosmetic outcome of a suprapubic approach (SA) were evaluated. Between 20...

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Autores principales: Taha, Anas, Taha-Mehlitz, Stephanie, Sternkopf, Ulrich, Sorba, Elena, Enodien, Bassey, Vorburger, Stephan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9369808/
https://www.ncbi.nlm.nih.gov/pubmed/35956193
http://dx.doi.org/10.3390/jcm11154579
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author Taha, Anas
Taha-Mehlitz, Stephanie
Sternkopf, Ulrich
Sorba, Elena
Enodien, Bassey
Vorburger, Stephan
author_facet Taha, Anas
Taha-Mehlitz, Stephanie
Sternkopf, Ulrich
Sorba, Elena
Enodien, Bassey
Vorburger, Stephan
author_sort Taha, Anas
collection PubMed
description Currently, cholecystectomy is performed laparoscopically. While the conventional approach (CA) with four access ports persists, other methods seek to reduce trauma or to optimize cosmetic results. In this study, the safety and cosmetic outcome of a suprapubic approach (SA) were evaluated. Between 2015 and 2016, patients undergoing elective cholecystectomy either by CA or by a suprapubic approach (SA) at our institution were included. The cosmetic outcome, postoperative morbidity, operative time and length of stay were evaluated. Pictures of the site of intervention were taken 6–12 months postoperatively and rated on a scale from 1 (unsatisfying aesthetic result) to 5 (excellent aesthetic result). Five “non-medical” and five “medical” raters as well as one board-certified plastic surgeon performed the ratings. A total of 70 patients were included (n = 28 SA, n = 42 CA). The two groups did not differ in baseline characteristics (age, gender, BMI). The SA group showed a significantly better aesthetic outcome compared to the CA group 4.8 (4.8–4.9) vs. 4.2 (3.8–4.4), (p > 0.001). Medical raters: 4.0 (3.8–4.2) vs. 4.8 (4.6–5.0), (p < 0.001); non-medical raters: 4.2 (3.8–4.6) vs. 5.0 (4.8–5.0), (p < 0.001); plastic surgeon: 4.0 (4.0–4.0) vs. 5.0 (5.0–5.0), (p < 0.001). Fair interrater consistency was demonstrated with an ICC of 0.47 (95% CI = 0.38–0.57). No significant difference in the complication rate (1 (3.5%) in SA vs. 6 (14%) in CA, (p = 0.3)), or the operating time 66 (50–86) vs. 70 (65–82) min, (p = 0.3), were observed. Patients stayed for a median of three (3–3) days in the SA group and 3 (3–4) days in the CA group (p = 0.08). This study demonstrated that the suprapubic approach is an appropriate alternative to conventional laparoscopic cholecystectomy, presenting a better cosmetic outcome with a similar complication rate.
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spelling pubmed-93698082022-08-12 Suprapubic Cholecystectomy Improves Cosmetic Outcome Compared to Classic Cholecystectomy Taha, Anas Taha-Mehlitz, Stephanie Sternkopf, Ulrich Sorba, Elena Enodien, Bassey Vorburger, Stephan J Clin Med Article Currently, cholecystectomy is performed laparoscopically. While the conventional approach (CA) with four access ports persists, other methods seek to reduce trauma or to optimize cosmetic results. In this study, the safety and cosmetic outcome of a suprapubic approach (SA) were evaluated. Between 2015 and 2016, patients undergoing elective cholecystectomy either by CA or by a suprapubic approach (SA) at our institution were included. The cosmetic outcome, postoperative morbidity, operative time and length of stay were evaluated. Pictures of the site of intervention were taken 6–12 months postoperatively and rated on a scale from 1 (unsatisfying aesthetic result) to 5 (excellent aesthetic result). Five “non-medical” and five “medical” raters as well as one board-certified plastic surgeon performed the ratings. A total of 70 patients were included (n = 28 SA, n = 42 CA). The two groups did not differ in baseline characteristics (age, gender, BMI). The SA group showed a significantly better aesthetic outcome compared to the CA group 4.8 (4.8–4.9) vs. 4.2 (3.8–4.4), (p > 0.001). Medical raters: 4.0 (3.8–4.2) vs. 4.8 (4.6–5.0), (p < 0.001); non-medical raters: 4.2 (3.8–4.6) vs. 5.0 (4.8–5.0), (p < 0.001); plastic surgeon: 4.0 (4.0–4.0) vs. 5.0 (5.0–5.0), (p < 0.001). Fair interrater consistency was demonstrated with an ICC of 0.47 (95% CI = 0.38–0.57). No significant difference in the complication rate (1 (3.5%) in SA vs. 6 (14%) in CA, (p = 0.3)), or the operating time 66 (50–86) vs. 70 (65–82) min, (p = 0.3), were observed. Patients stayed for a median of three (3–3) days in the SA group and 3 (3–4) days in the CA group (p = 0.08). This study demonstrated that the suprapubic approach is an appropriate alternative to conventional laparoscopic cholecystectomy, presenting a better cosmetic outcome with a similar complication rate. MDPI 2022-08-05 /pmc/articles/PMC9369808/ /pubmed/35956193 http://dx.doi.org/10.3390/jcm11154579 Text en © 2022 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
Taha, Anas
Taha-Mehlitz, Stephanie
Sternkopf, Ulrich
Sorba, Elena
Enodien, Bassey
Vorburger, Stephan
Suprapubic Cholecystectomy Improves Cosmetic Outcome Compared to Classic Cholecystectomy
title Suprapubic Cholecystectomy Improves Cosmetic Outcome Compared to Classic Cholecystectomy
title_full Suprapubic Cholecystectomy Improves Cosmetic Outcome Compared to Classic Cholecystectomy
title_fullStr Suprapubic Cholecystectomy Improves Cosmetic Outcome Compared to Classic Cholecystectomy
title_full_unstemmed Suprapubic Cholecystectomy Improves Cosmetic Outcome Compared to Classic Cholecystectomy
title_short Suprapubic Cholecystectomy Improves Cosmetic Outcome Compared to Classic Cholecystectomy
title_sort suprapubic cholecystectomy improves cosmetic outcome compared to classic cholecystectomy
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9369808/
https://www.ncbi.nlm.nih.gov/pubmed/35956193
http://dx.doi.org/10.3390/jcm11154579
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