Pfannenstiel incision versus iliac fossa incision for retrieval of resected specimen after laparoscopic radical nephrectomy: a prospective randomised parallel arm study.

Abstract

Purpose: Although laparoscopic radical nephrectomy (LRN) is the standard of care for large and complex malignant renal masses, the location of the incision for kidney retrieval remains a point of debate, and no clear-cut guidelines exist. This study aimed to compare the outcomes of kidney specimen retrieval after LRN using either a Pfannenstiel incision (PFN) or an iliac fossa incision (IFN).

Methods: This was an open-labelled, parallel-group, randomised trial. The calculated sample was 52 [26 = each arm]. The primary endpoint was the surgical site pain in the immediate postoperative period measured by the Universal Pain Assessment Tool, every fourth hour till 48 h. Secondary endpoints were total operative time, incision length, blood loss during specimen retrieval, length of postoperative hospital stay, wound site cosmesis [Manchester scar scale] at 3 months postoperatively, and wound complications between the groups in the early postoperative period.

Results: Demographic characteristics were comparable in both groups. Pain scores demonstrated a significant difference in favour of the Pfannenstiel incision group, particularly at 12, 16, 20, 24, 36 and 40 h postoperatively. There were no significant differences between groups on the other parameters.

Conclusion: The PFN has significantly less operative site pain than IFN following LRN.