title: Vertical transumbilical incision versus left lower transverse incision for specimen retrieval during laparoscopic colorectal surgery.
abstract: BACKGROUND
  This study compared the short-term surgical outcomes of the vertical transumbilical incision with the left lower transverse incision for specimen retrieval in laparoscopic colorectal cancer surgery.
  
  
  METHODS
  One hundred forty-seven consecutive patients scheduled for laparoscopic surgery for sigmoid colon and rectal cancer between April 2010 and December 2010 were classified into one of the two groups according to the site of the minilaparotomy: a transumbilical incision group (n = 92) and a left lower transverse incision group (n = 55).
  
  
  RESULTS
  Demographic data, operation time, estimated blood loss, frequency of transfusion, size of the tumor, number of harvested lymph nodes, distal resection margins, time to first flatus, and length of hospital stay were similar between the two groups. Postoperative pain scores were also similar between the two groups. The length of the minilaparotomy incision was shorter in the transumbilical group than the left lower transverse group at operation (mean, 4.6 vs. 6.2 cm, p = 0.000). The postoperative mean satisfaction score was higher in the transumbilical group, but this was not statistically significant (7.6 vs. 7.1, p = 0.224). Fourteen patients in the transumbilical group and 7 patients in the left lower transverse group developed wound-related complications (p = 0.810), including two cases of incisional hernia, both in the transumbilical group. High body mass index (≥25 kg/m(2)) and longer operative time (≥180 min) were risk factors for wound complications on univariate analysis.
  
  
  CONCLUSIONS
  Transumbilical minilaparotomy in laparoscopic colorectal surgery is a good alternative approach with acceptable wound complications.
authors.affiliation: Department of Colon and Rectal Surgery, Chonnam National University Hwasun Hospital, Gwangju, Korea.
authors.forename: S W
authors.initials: SW
authors.lastname: Lim
authors.forename: J W
authors.initials: JW
authors.lastname: Huh
authors.forename: Y J
authors.initials: YJ
authors.lastname: Kim
authors.forename: H R
authors.initials: HR
authors.lastname: Kim
mesh_terms: D034861:Abdominal Wall / Q000601:surgery*; D000368:Aged; D057868:Anastomotic Leak / Q000209:etiology / Q000601:surgery; D015992:Body Mass Index; D003110:Colonic Neoplasms / Q000601:surgery*; D005260:Female; D006406:Hematoma / Q000209:etiology; D006554:Hernia, Umbilical / Q000209:etiology; D006801:Humans; D045823:Ileus / Q000209:etiology; D010535:Laparoscopy / Q000009:adverse effects* / Q000379:methods*; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D010149:Postoperative Pain / Q000209:etiology; D017060:Patient Satisfaction; D019106:Postoperative Hemorrhage / Q000209:etiology; D012004:Rectal Neoplasms / Q000601:surgery*; D012307:Risk Factors; D013530:Surgical Wound Infection / Q000209:etiology; D014472:Umbilicus / Q000601:surgery*