Transverse versus midline incision for upper abdominal surgery.
OBJECTIVE
Transverse and midline abdominal incisions are both commonly used for laparotomy to perform surgery on the pancreas and stomach, but comparative data are limited, especially from prospective randomized trials.


METHODS
During a predefined 2-year recruitment period, 94 patients undergoing an elective major laparotomy for disorders of the pancreas or stomach were enrolled in this study. The outcome measures were pulmonary function, incisional pain, and wound characteristics.


RESULTS
The operation groups were equally divided according to the type of incision used. The patients who underwent transverse incision laparotomy had significantly better postoperative pulmonary function and significantly less postoperative incisional pain than those who underwent midline incision laparotomy (P < 0.05), but there were no differences in morbidity and the incidence of wound complications.


CONCLUSIONS
Performing a transverse incision for surgery on the pancreas or stomach results in better postoperative pulmonary function and less incisional pain than a midline incision, without affecting postoperative morbidity.
Proske
Jan Martin
JM
Department of General, Vascular, Thoracic and Visceral Surgery, Charité, Campus Mitte, Humboldt University Berlin, Schumannstrasse 20/21, D-10117 Berlin, Germany.
Zieren
Jürgen
J
Müller
Joachim M
JM
D062109:Dermatologic Surgical Procedures; D005260:Female; D006801:Humans; D007813:Laparotomy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010149:Postoperative Pain / Q000453:epidemiology; D010182:Pancreatic Diseases / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology; D011446:Prospective Studies; D012129:Respiratory Function Tests; D013272:Stomach Diseases / Q000601:surgery*