Impact of Abdominal Incision Type on Postoperative Pain and Quality of Life Following Hepatectomy View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2021-02-17

AUTHORS

Genki Watanabe, Takeaki Ishizawa, Satoshi Yamamoto, Takashi Kokudo, Yujiro Nishioka, Akihiko Ichida, Nobuhisa Akamatsu, Junichi Kaneko, Junichi Arita, Kiyoshi Hasegawa

ABSTRACT

BackgroundThe aim of this prospective study was to analyze the impact of abdominal incision type on postoperative pain and quality of life (QOL) in hepatectomy.MethodsIn patients undergoing hepatectomy by open, hybrid, or pure laparoscopic approaches, we classified abdominal incisions as: pure laparoscopic (LAP), midline (MID), J-shaped (J), and J-shaped incision plus thoracotomy (TRC). Postoperative pain was measured on postoperative day (POD) 3, 7, 30, and 90 using a visual analog scale (VAS). QOL was evaluated using the short-form-36 questionnaire preoperatively and on POD 30 and 90.ResultsWe categorized 165 patients into LAP (n = 9, 5%), MID (n = 21, 13%), J (n = 95, 58%), and TRC (n = 40, 24%) groups. Median VAS scores on PODs 3/7/30/90 were: LAP, 27.5/7.5/10/10; MID, 30/10/15/5; J, 50/27.5/20/10, and TRC, 50/30/30/19. The J and TRC groups had significantly higher VAS scores vs. MID on PODs 3 and 7; the LAP and MID groups did not differ significantly. No significant positive correlations were observed between incision length and postoperative VAS, when we stratified patients into two groups according to the presence or absence of a transverse incision. Physical QOL summary scores did not return to preoperative levels even on POD 90, in patients with an additional transverse incision. Mental QOL summary scores worsened with postoperative complications rather than with abdominal incision type.ConclusionsTransverse incisions, rather than incision length, led to worse midline incision pain and poorer QOL recovery post-hepatectomy. A hybrid approach may be a considerable option when pure laparoscopic hepatectomy is technically difficult.Trial registrationThis study was registered in the UMIN Clinical Trials Registry (registration number: UMIN000017467; http://www.umin.ac.jp/ctr/index.htm) More... »

PAGES

1887-1896

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URI

http://scigraph.springernature.com/pub.10.1007/s00268-021-05992-x

DOI

http://dx.doi.org/10.1007/s00268-021-05992-x

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1135428479

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/33598727


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