Vertical transumbilical incision versus left lower transverse incision for specimen retrieval during laparoscopic colorectal surgery

Abstract

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. 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). 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. 6.2cm, 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 (≥25kg/m(2)) and longer operative time (≥180min) were risk factors for wound complications on univariate analysis. Transumbilical minilaparotomy in laparoscopic colorectal surgery is a good alternative approach with acceptable wound complications.