Comparison of postoperative pain at umbilical wound after conventional laparoscopic cholecystectomy between transumbilical and infraumbilical incisions: a randomized control trial

© 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 rand...

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Main Authors: Boonying Siribumrungwong, Trirat Chunsirisub, Palin Limpavitayaporn, Assanee Tongyoo, Ekkapak Sriussadaporn, Chatchai Mingmalairak, Weerayut Thowprasert, Ammarin Thakkinstian
Other Authors: Faculty of Medicine, Ramathibodi Hospital, Mahidol University
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Published: 2020
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Online Access:https://repository.li.mahidol.ac.th/handle/123456789/51644
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spelling th-mahidol.516442020-01-27T16:49:39Z Comparison of postoperative pain at umbilical wound after conventional laparoscopic cholecystectomy between transumbilical and infraumbilical incisions: a randomized control trial Boonying Siribumrungwong Trirat Chunsirisub Palin Limpavitayaporn Assanee Tongyoo Ekkapak Sriussadaporn Chatchai Mingmalairak Weerayut Thowprasert Ammarin Thakkinstian Faculty of Medicine, Ramathibodi Hospital, Mahidol University Faculty of Medicine, Thammasat University Medicine © 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. 2020-01-27T09:49:39Z 2020-01-27T09:49:39Z 2019-05-15 Article Surgical Endoscopy. Vol.33, No.5 (2019), 1578-1584 10.1007/s00464-018-6447-y 14322218 09302794 2-s2.0-85064936706 https://repository.li.mahidol.ac.th/handle/123456789/51644 Mahidol University SCOPUS https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85064936706&origin=inward
institution Mahidol University
building Mahidol University Library
continent Asia
country Thailand
Thailand
content_provider Mahidol University Library
collection Mahidol University Institutional Repository
topic Medicine
spellingShingle Medicine
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
description © 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.
author2 Faculty of Medicine, Ramathibodi Hospital, Mahidol University
author_facet Faculty of Medicine, Ramathibodi Hospital, Mahidol University
Boonying Siribumrungwong
Trirat Chunsirisub
Palin Limpavitayaporn
Assanee Tongyoo
Ekkapak Sriussadaporn
Chatchai Mingmalairak
Weerayut Thowprasert
Ammarin Thakkinstian
format Article
author Boonying Siribumrungwong
Trirat Chunsirisub
Palin Limpavitayaporn
Assanee Tongyoo
Ekkapak Sriussadaporn
Chatchai Mingmalairak
Weerayut Thowprasert
Ammarin Thakkinstian
author_sort Boonying Siribumrungwong
title Comparison of postoperative pain at umbilical wound after conventional laparoscopic cholecystectomy between transumbilical and infraumbilical incisions: a randomized control trial
title_short Comparison of postoperative pain at umbilical wound after conventional laparoscopic cholecystectomy between transumbilical and infraumbilical incisions: a randomized control trial
title_full Comparison of postoperative pain at umbilical wound after conventional laparoscopic cholecystectomy between transumbilical and infraumbilical incisions: a randomized control trial
title_fullStr Comparison of postoperative pain at umbilical wound after conventional laparoscopic cholecystectomy between transumbilical and infraumbilical incisions: a randomized control trial
title_full_unstemmed Comparison of postoperative pain at umbilical wound after conventional laparoscopic cholecystectomy between transumbilical and infraumbilical incisions: a randomized control trial
title_sort comparison of postoperative pain at umbilical wound after conventional laparoscopic cholecystectomy between transumbilical and infraumbilical incisions: a randomized control trial
publishDate 2020
url https://repository.li.mahidol.ac.th/handle/123456789/51644
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