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Vertical compared with transverse incisions in abdominal surgery.
1Department of Surgical Gastroenterology, University of Copenhagen, Hvidovre Hospital, Hvidovre, Denmark. ttgrant@dadlnet.dk
The European Journal of Surgery = Acta Chirurgica
|May 17, 2001
Summary
Transverse abdominal incisions are recommended over vertical ones due to fewer complications like pain and incisional hernias. Vertical incisions offer faster access and easier extension for emergency abdominal surgery.
Area of Science:
- Surgical techniques
- Abdominal surgery
- Evidence-based medicine
Background:
- Vertical and transverse laparotomy incisions are common in abdominal surgery.
- Choosing the optimal incision type is crucial for patient outcomes.
Purpose of the Study:
- To establish a consensus on the comparative effectiveness of vertical versus transverse laparotomy incisions.
- To evaluate postoperative complications associated with each incision type.
Main Methods:
- A systematic review and meta-analysis of randomized controlled trials (RCTs) and retrospective studies.
- Studies compared postoperative complications following vertical and transverse abdominal incisions.
- Complications assessed included pain, pulmonary issues, wound complications, and hernias.
Main Results:
- Transverse incisions provide comparable access to vertical incisions.
- Transverse incisions are associated with significantly less postoperative pain and fewer pulmonary complications.
- Vertical incisions are quicker to perform and easier to extend, but have higher rates of burst abdomen and incisional hernia.
Conclusions:
- Transverse incisions are anatomically and physiologically superior, leading to fewer early and late complications.
- Transverse incisions should be recommended for routine abdominal surgery.
- Vertical midline incisions remain preferable for emergency situations requiring rapid access or uncertain diagnoses.