Is it time for colorectal surgeons to follow the gynaecologists when removing left sided specimens?
Published Date: 15th July 2020
Publication Authors: Javed M, Thomas E, West C, Chadwick M, Samad A, Rajaganeshan R
Purpose
To analyze different extraction sites for specimen extraction following left sided colorectal resections and risk for developing an IH.
Methods
Retrospective analysis of 107 patients undergoing laparoscopic left sided colorectal resections. Patients were divided into 3 groups based on extraction sites; midline, transverse (right or left) or pfannenstiel incisions. Data regarding patient demographics, peri‐operative variables and clinical and/or radiological follow up were recorded, with particular focus on development of an IH.
Results
148 left sided resections were performed between 01.01.2015 and 31.12.2017, 41 patients were excluded. Median age of study cohort was 69 years (IQR = 59–76) with M: F of 63:44. Majority of patients had BMI of < 30 (69%) and median ASA was 2 (range 1–3). Median duration of clinical and radiological follow up were 24 months (IQR = 17–31) and 27 months (IQR = 23–36.5) respectively. 38 patients (35%) had a midline extraction site, 49 patients (46%) had specimen extracted via transverse (right or left iliac fossae) incisions and pfannenstiel incision was used in 20 patients (19%). Overall incidence of IH was 12/107 = 11%. The incidence of IH within the 3 groups were; midline: 5/38 = 13%, transverse: 7/49 = 14% and pfannenstiel: 0/20. There was no statistically significant difference between midline vs transverse incisions however pfannenstiel incisions were associated with lower incidence of IH compared to non‐pfannenstiel incisions (P value < 0.05).
Conclusion
IH most commonly develop at the midline and transverse extraction sites. Pfannenstiel incisions are associated with a significantly lower incidence of IH formation.
Javed, MA; Thomas, E; West, C; Chadwick, M; Samad, A; Rajaganeshan, R. (2020). Is it time for colorectal surgeons to follow the gynaecologists when removing left sided specimens?. Colorectal Disease;. 22 (S1), 17-18