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Midline or transverse abdominal incision for right‐sided colon cancer—a randomized trial
Author(s) -
Lindgren P. G.,
Nordgren S. R.,
Öresland T.,
Hultén L.
Publication year - 2001
Publication title -
colorectal disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.029
H-Index - 89
eISSN - 1463-1318
pISSN - 1462-8910
DOI - 10.1111/j.1463-1318.2001.00203.x
Subject(s) - medicine , visual analogue scale , surgery , anesthesia , randomized controlled trial , colorectal cancer , pulmonary function testing , surgical incision , right hemicolectomy , cancer
Objective The influence of the type of abdominal incision on post‐operative pain and pulmonary function was investigated in patients operated upon for a right‐sided cancer of the large bowel. Patients and methods Fifty‐three patients scheduled for a right hemicolectomy due to a right‐sided colon cancer were randomized to a median vertical (M) or a transverse incision (T). Forty patients, 23 with a M and 17 with a T incision, completed the study and could be evaluated. Pain at rest and after physical activity was assessed with a visual analogue scale, and was also measured as reflected in the need for analgesics. Respiratory function was assessed with pre‐ and post‐operative spirometry. Results Pain after activity was significantly less in patients with a T incision. This group also needed less analgesia. Vital capacity (VC) and forced expiratory volume in 1 s (FEV 1.0) were profoundly reduced after surgery in both groups of patients, but improvement of respiratory function was faster in patients with a transverse incision. No problem with access to the operative field was noted. Conclusion We conclude that a transverse incision is preferable to a midline incision and should be used in right hemicolectomy. This abdominal incision reduces effort‐induced pain and interferes less with post‐operative pulmonary function, and may reduce the risk of pulmonary complications.