Adequate staging for uterine XXXX can be performed through Pfannenstiel incisions.

@entity1 @entity5 @entity190 @entity1600 @entity260
OBJECTIVE: To determine if the type of operative incision influences the adequacy of surgical staging in @entity1 with uterine @entity5 . METHODS: All @entity1 with uterine @entity5 referred to the Swedish Medical Center @entity5 Institute for adjuvant radiotherapy between June 1, 1989, and June 1, 1999, who underwent comprehensive surgical staging and for whom complete records could be obtained were eligible. Data on type of incision, weight, medical comorbidities, histology, total number and distribution of @entity1600 ( @entity1600 ), estimated @entity190 , complications, and length of stay were abstracted retrospectively. Statistical analysis with two-tailed Student t test, chi(2), Fisher's exact, and Kaplan-Meier survival curves were performed. RESULTS: Five hundred four @entity1 with @entity5 were referred to the @entity5 Institute with 332 meeting inclusion criteria. A vertical midline incision (ML) was used in 236 (72%) while 96 (28%) received a Pfannenstiel incision (PI). No panniculectomies were performed. There were no statistically significant differences in age, weight, stage, histology, comorbidities, or estimated @entity190 between the ML and PI groups. ML was associated with significantly more @entity260 (34 vs. 7; P = 0.003). When compared to ML a greater number of total @entity1600 (21.0 vs. 16.8; P = 0.001) and a comparable number of pelvic @entity1600 (13.7 vs. 12.2; P = 0.14) were procured through a PI. More @entity1 with a ML (72% vs. 63%; P = 0.13) had para-aortic @entity1600 (PALN) dissected; however, when obtained equivalent numbers of nodes were removed (3.52 vs. 4.36; P = 0.14). Overall, the median length of stay was statistically shorter for those @entity1 operated on via a PI (4 vs. 3 days; P = 0.007). The projected 5-year disease-free (83% vs. 85%) and disease-specific (87% vs. 85%) survival was unaffected by incision. In the heaviest quartile of @entity1 (>180 lb), a statistically greater number of total @entity1600 (23.3 vs. 16.5; P = 0.005) and pelvic @entity1600 (16.7 vs. 11.5; P = 0.05) were obtained with a PI. Again, PALN were sampled more frequently (67% vs. 56%; P = 0.45) in @entity1 with a ML, but the mean @entity1600 yield was no different (3.91 vs. 5.20; P = 0.37). Likewise, in this heaviest quartile, there were no statically significant differences in operative complications (7 vs. 1; P = 0.43) with either incision. CONCLUSIONS: Comprehensive surgical staging for @entity5 can be adequately performed through a PI without greater morbidity or mortality. By using this surgical approach, @entity1 with uterine @entity5 can benefit from the inherent benefits previously described for PI. Appropriate @entity1 selection, however, is necessary.
