Publication: Comparison of postoperative pain at umbilical wound after conventional laparoscopic cholecystectomy between transumbilical and infraumbilical incisions: a randomized control trial
Issued Date
2019-05-15
Resource Type
ISSN
14322218
09302794
09302794
Other identifier(s)
2-s2.0-85064936706
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Mahidol University
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SCOPUS
Bibliographic Citation
Surgical Endoscopy. Vol.33, No.5 (2019), 1578-1584
Suggested Citation
Boonying Siribumrungwong, Trirat Chunsirisub, Palin Limpavitayaporn, Assanee Tongyoo, Ekkapak Sriussadaporn, Chatchai Mingmalairak, Weerayut Thowprasert, Ammarin Thakkinstian Comparison of postoperative pain at umbilical wound after conventional laparoscopic cholecystectomy between transumbilical and infraumbilical incisions: a randomized control trial. Surgical Endoscopy. Vol.33, No.5 (2019), 1578-1584. doi:10.1007/s00464-018-6447-y Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/51644
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Title
Comparison of postoperative pain at umbilical wound after conventional laparoscopic cholecystectomy between transumbilical and infraumbilical incisions: a randomized control trial
Abstract
© 2018, Springer Science+Business Media, LLC, part of Springer Nature. Background: Transumbilical incision has been applied in single-incision laparoscopy. Evidence for the effect of transumbilical incision on postoperative pain compared with infraumbilical incision is still lacking. Methods: A randomized controlled trial (RCT) was conducted in a university hospital. Patients who underwent conventional laparoscopic cholecystectomy were randomized to have transumbilical or infraumbilical incision. Postoperative pain was measured using visual analog score at 6, 24 h, and 7 days post operation. Secondary outcomes were analgesic usage, length of stay, superficial surgical site infection (SSI), wound numbness, and hypersensitivity. Risk ratio and mean difference (MD) along with their 95% confidence intervals (CIs) were estimated. Adjusted analysis was done, if clinical unbalanced characteristics presented. The study was registered at http://ClinicalTrial.gov (ID NCT02738710). Results: A total of 102 patients were enrolled in which 51 patients were randomized to each interventional group. Postoperative pain was not significantly different between the groups with the MD of − 0.07 (95% CI − 0.47, 0.35). Paracetamol usage was significantly 1 tab (95% CI − 1.9, − 0.1) less after transumbilical incision, but this was not significant after adjusting for unbalanced characteristics. Superficial SSI rate was much higher in the transumbilical than the infraumbilical group, i.e., 16 versus 4%, but this was not significant (p = 0.070). Satisfaction scores at 3 months were not different between the groups, with the corresponding means of 8.9 [standard deviation (SD) 1.3] and 9.0 (SD 1.0). Conclusions: Transumbilical incision had non-significant different pain compared to infraumbilical incision. Most patients in both groups were satisfied with the operation at 3 months. A further large RCT is required for comparing SSI between the two incisions.