Le. Mendez et al., Evaluation of the Pfannenstiel incision for radical abdominal hysterectomywith pelvic and para-aortic lymphadenectomy, INT J GYN C, 9(5), 1999, pp. 418-420
Radical abdominal hysterectomy with pelvic and para-aortic lymphadenectomy
(RAH/P + PAL) has classically been described through a low midline vertical
incision. Transverse incisions have been used with good results for variou
s pelvic surgical procedures. Hesitancy has been encountered when utilizing
these transverse incisions in gynecologic oncology patients. In most studi
es, muscle-splitting transverse incisions seem to be of equal efficacy as m
idline vertical incisions in regards to surgical exposure and clinicopathol
ogic data obtained and are known to be superior in cosmesis and postoperati
ve morbidity. A retrospective chart review was performed to identify 25 pat
ients who underwent RAH/P + PAL for stage I carcinoma of the cervix from 19
90 to 1998 through a nonmuscle splitting (Pfannenstiel) abdominal incision.
All patients were seen and had follow-up in the Division of Gynecologic On
cology, University of Miami School of Medicine/Jackson Memorial Medical Cen
ter (Miami, FL). Data were collected on various clinical and surgical param
eters including height/weight, operative time, blood loss, number of lymph
nodes obtained, length of hospital stay, and postoperative complications. A
nalysis of the data revealed that operative time and average blood loss wer
e within acceptable parameters. The yield at lymphadenectomy for pelvic and
para-aortic lymph nodes was also respectable. Postoperative complications
were minimal and there were no wound complications reported. Therefore, the
Pfannenstiel incision can be safely utilized in a select group of patients
undergoing RAH/P + PAL.