TY - JOUR
T1 - A J-Shaped Subcostal Incision Reduces the Incidence of Abdominal Wall Complications in Liver Transplantation
AU - Heisterkamp, J
AU - Marsman, HA
AU - Eker, H
AU - Metselaar, Herold
AU - Tilanus, Hugo
AU - Kazemier, G
PY - 2008
Y1 - 2008
N2 - A novel J-shaped incision for liver transplantation was introduced in attempt to reduce the wound-related complication rate while maintaining comparable access. Some 58 consecutive patients with the classic Mercedes incision were compared with the following 60 consecutive patients with a J-shaped incision, Nine of 60 patients (15%) with a J-shaped incision were converted to an extensive incision. The duration of surgery did not differ between both groups, and relaparotomy rates were comparable in both groups (45% versus 31%, P = 0.487) whereas the early wound-related morbidity was significantly reduced in the J-shaped incision group (3% versus 19%, P = 0.009), as well as incisional hernia rate (7% versus 24%, P = 0.002, corrected for different length of follow-up). Other factors such as previous surgery, ascites, abdominal drainage, retransplantation, and indications for transplantation did not differ between both groups and were not predictive of wound-related morbidity or incisional hernia. We therefore conclude that a J-shaped incision should be the incision of choice in liver transplantation. This new, seemingly minor modification reduces wound infections, fascial dehiscence, and incisional hernia. Liver Transpl 14:1655-1658, 2008. (C) 2008 AASLD.
AB - A novel J-shaped incision for liver transplantation was introduced in attempt to reduce the wound-related complication rate while maintaining comparable access. Some 58 consecutive patients with the classic Mercedes incision were compared with the following 60 consecutive patients with a J-shaped incision, Nine of 60 patients (15%) with a J-shaped incision were converted to an extensive incision. The duration of surgery did not differ between both groups, and relaparotomy rates were comparable in both groups (45% versus 31%, P = 0.487) whereas the early wound-related morbidity was significantly reduced in the J-shaped incision group (3% versus 19%, P = 0.009), as well as incisional hernia rate (7% versus 24%, P = 0.002, corrected for different length of follow-up). Other factors such as previous surgery, ascites, abdominal drainage, retransplantation, and indications for transplantation did not differ between both groups and were not predictive of wound-related morbidity or incisional hernia. We therefore conclude that a J-shaped incision should be the incision of choice in liver transplantation. This new, seemingly minor modification reduces wound infections, fascial dehiscence, and incisional hernia. Liver Transpl 14:1655-1658, 2008. (C) 2008 AASLD.
U2 - 10.1002/lt.21594
DO - 10.1002/lt.21594
M3 - Article
VL - 14
SP - 1655
EP - 1658
JO - Liver Transplantation
JF - Liver Transplantation
SN - 1527-6465
IS - 11
ER -