A retrospective analysis of radical hysterectomies done for cervical cancer

Is there a role for the Pfannenstiel incision?

Dennis R. Scribner, Scott A. Kamelle, Natalie Gould, Todd Tillmanns, Marc A. Wilson, Scott McMeekin, Michael A. Gold, Robert S. Mannel

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Objective. The goal of this work was to review patients with early-stage cervical cancer undergoing radical hysterectomy, comparing Pfannenstiel and vertical midline incisions for surgical feasibility, complications, and length of stay. Methods. Patients were identified by searching our institutional database. Data were collected from review of each patient's medical record, including demographics, cancer stage, histology, procedural information, length of stay, and complications. Associations between variables were studied using X2 and two-tailed t tests. Multivariate analysis was performed using logistic regression. Results. Between March 1996 and June 2000, 113 patients from the University and Presbyterian Hospitals, Oklahoma City, Oklahoma, underwent radical hysterectomy and pelvic and paraortic lymph node dissection with records available for review. Group 1 consisted of 40 patients who had vertical incisions and group 2 consisted of 73 patients who had Pfannenstiel incisions. There was no difference in race, number of previous abdominal surgeries, distribution of stage, histology, percentage of type III hysterectomies, estimated blood loss, nodal counts, pathologic margin positivity, and postoperative complications among the two groups. Group 2 were younger (41.6 vs 46.5, P = 0.02) and had a lower average QI than group 1 (24.9 vs 28.9, P = 0.001). Group 2 also had a shorter average hospital stay (4.6 days vs 5.8 days, P = 0.04) and shorter operative time (215 min vs 273 min, P = 0.09). Multivariate analysis resulted in Pfannenstiel incisions (P = 0.002), younger age (P = 0.004), and smaller body mass index (P = 0.01) being significant predictors of length of stay. Conclusions. Pfannenstiel incisions are feasible without increased morbidity and equal nodal retrieval as compared with vertical midline incisions in patients with early-stage cervical cancer. Pfannenstiel incisions may offer an advantage besides cosmesis in the form of shorter operating room time and earlier discharge from the hospital.

Original languageEnglish (US)
Pages (from-to)481-484
Number of pages4
JournalGynecologic Oncology
Volume81
Issue number3
DOIs
StatePublished - Jan 1 2001
Externally publishedYes

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Hysterectomy
Uterine Cervical Neoplasms
Length of Stay
Histology
Multivariate Analysis
Operating Rooms
Operative Time
Lymph Node Excision
Medical Records
Body Mass Index
Logistic Models
Demography
Databases
Morbidity
Neoplasms

All Science Journal Classification (ASJC) codes

  • Oncology
  • Obstetrics and Gynecology

Cite this

A retrospective analysis of radical hysterectomies done for cervical cancer : Is there a role for the Pfannenstiel incision? / Scribner, Dennis R.; Kamelle, Scott A.; Gould, Natalie; Tillmanns, Todd; Wilson, Marc A.; McMeekin, Scott; Gold, Michael A.; Mannel, Robert S.

In: Gynecologic Oncology, Vol. 81, No. 3, 01.01.2001, p. 481-484.

Research output: Contribution to journalArticle

Scribner, Dennis R. ; Kamelle, Scott A. ; Gould, Natalie ; Tillmanns, Todd ; Wilson, Marc A. ; McMeekin, Scott ; Gold, Michael A. ; Mannel, Robert S. / A retrospective analysis of radical hysterectomies done for cervical cancer : Is there a role for the Pfannenstiel incision?. In: Gynecologic Oncology. 2001 ; Vol. 81, No. 3. pp. 481-484.
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abstract = "Objective. The goal of this work was to review patients with early-stage cervical cancer undergoing radical hysterectomy, comparing Pfannenstiel and vertical midline incisions for surgical feasibility, complications, and length of stay. Methods. Patients were identified by searching our institutional database. Data were collected from review of each patient's medical record, including demographics, cancer stage, histology, procedural information, length of stay, and complications. Associations between variables were studied using X2 and two-tailed t tests. Multivariate analysis was performed using logistic regression. Results. Between March 1996 and June 2000, 113 patients from the University and Presbyterian Hospitals, Oklahoma City, Oklahoma, underwent radical hysterectomy and pelvic and paraortic lymph node dissection with records available for review. Group 1 consisted of 40 patients who had vertical incisions and group 2 consisted of 73 patients who had Pfannenstiel incisions. There was no difference in race, number of previous abdominal surgeries, distribution of stage, histology, percentage of type III hysterectomies, estimated blood loss, nodal counts, pathologic margin positivity, and postoperative complications among the two groups. Group 2 were younger (41.6 vs 46.5, P = 0.02) and had a lower average QI than group 1 (24.9 vs 28.9, P = 0.001). Group 2 also had a shorter average hospital stay (4.6 days vs 5.8 days, P = 0.04) and shorter operative time (215 min vs 273 min, P = 0.09). Multivariate analysis resulted in Pfannenstiel incisions (P = 0.002), younger age (P = 0.004), and smaller body mass index (P = 0.01) being significant predictors of length of stay. Conclusions. Pfannenstiel incisions are feasible without increased morbidity and equal nodal retrieval as compared with vertical midline incisions in patients with early-stage cervical cancer. Pfannenstiel incisions may offer an advantage besides cosmesis in the form of shorter operating room time and earlier discharge from the hospital.",
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T2 - Is there a role for the Pfannenstiel incision?

AU - Scribner, Dennis R.

AU - Kamelle, Scott A.

AU - Gould, Natalie

AU - Tillmanns, Todd

AU - Wilson, Marc A.

AU - McMeekin, Scott

AU - Gold, Michael A.

AU - Mannel, Robert S.

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AB - Objective. The goal of this work was to review patients with early-stage cervical cancer undergoing radical hysterectomy, comparing Pfannenstiel and vertical midline incisions for surgical feasibility, complications, and length of stay. Methods. Patients were identified by searching our institutional database. Data were collected from review of each patient's medical record, including demographics, cancer stage, histology, procedural information, length of stay, and complications. Associations between variables were studied using X2 and two-tailed t tests. Multivariate analysis was performed using logistic regression. Results. Between March 1996 and June 2000, 113 patients from the University and Presbyterian Hospitals, Oklahoma City, Oklahoma, underwent radical hysterectomy and pelvic and paraortic lymph node dissection with records available for review. Group 1 consisted of 40 patients who had vertical incisions and group 2 consisted of 73 patients who had Pfannenstiel incisions. There was no difference in race, number of previous abdominal surgeries, distribution of stage, histology, percentage of type III hysterectomies, estimated blood loss, nodal counts, pathologic margin positivity, and postoperative complications among the two groups. Group 2 were younger (41.6 vs 46.5, P = 0.02) and had a lower average QI than group 1 (24.9 vs 28.9, P = 0.001). Group 2 also had a shorter average hospital stay (4.6 days vs 5.8 days, P = 0.04) and shorter operative time (215 min vs 273 min, P = 0.09). Multivariate analysis resulted in Pfannenstiel incisions (P = 0.002), younger age (P = 0.004), and smaller body mass index (P = 0.01) being significant predictors of length of stay. Conclusions. Pfannenstiel incisions are feasible without increased morbidity and equal nodal retrieval as compared with vertical midline incisions in patients with early-stage cervical cancer. Pfannenstiel incisions may offer an advantage besides cosmesis in the form of shorter operating room time and earlier discharge from the hospital.

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