Comparison of midline and Pfannenstiel incision for radical hysterectomy with pelvic and paraaortic lymphadenectomy in cervical carcinoma

Abstract

To compare Pfannenstiel and midline incisions with respect to efficacy and early postoperative surgical site complications in patients with early stage cervical carcinoma. Patients with cervical carcinoma who underwent radical hysterectomy during 1995-2004 are retrospectively reviewed. There were 40 patients in the Pfannenstiel group and 71 patients in the midline group. Patients' age, type of incision, operative time, hospitalization length, postoperative surgical site complications, pre and postoperative Hb levels, number of extracted pelvic and paraaortic lymph nodes were the variables collected from the patients' files and oncology follow-up forms. Mean age (53.5+/-6.96 vs 55.9+/-10.5, P=0.2) and preoperative Hb levels of patients (12.52+/-1.48 vs 12.94+/-1.34, P=0.17) were not statistically different in midline and Pfannenstiel groups, respectively. Operative time (141.8+/-36 vs 135.8+/-31 min), number of extracted lymph nodes in pelvic (23.05+/-9.7 vs 23.5+/-8.07) and paraaortic areas (3.17+/-1.68 vs 2.66+/-1.15) were not significantly different among the midline and Pfannenstiel groups, respectively (P>0.05). Although postoperative incisional complications were more common in the midline group, this difference did not reach a significant level (11.3% vs 7.5%, P=0.52). Duration of hospitalization was not significantly different between the midline and Pfannenstiel groups, respectively (6.3+/-2.69 vs 6.2+/-2.72 days, P=0.21). Multivariate analysis revealed postoperative Hb levels to be significantly different among the groups (P=0.017, OR=1.59, 95% CI: 1.08-2.35). Pfannenstiel incision can be used for radical hysterectomy with pelvic and paraaortic lymphadenectomy in selected patients with cervical carcinoma, without any negative influence on optimal resectability of tumor and surgical morbidity.