Comparison of modified Cherney incision and vertical midline incision for management of early stage cervical cancer

다국어 초록 (Multilingual Abstract)

Objective: The aim of this study was to compare operative feasibility and surgical outcome of the modified Cherney
incision and vertical midline incision in patients undergoing radical hysterectomy and pelvic lymphadenectomy.
Methods: Between March 2005 and December 2007, retrospective data of 78 patients (n=17; modified Cherney
incision, n=61; vertical midline incision) with early stage cervical cancer who received radical hysterectomy and pelvic
lymphadenectomy were reviewed.
Results: Baseline characteristics of patients who underwent modified Cherney incision and vertical midline incision
were similar except for age (mean±SD: 32.3±3.4 yr vs. 52.5±8.4 yr, p＜0.001). Patients who received modified
Cherney incision had earlier initiation of soft diet (mean±SD: 46.5±19.5 hr vs. 56.4±25.4 hr, p＜0.016) and shorter
hospital stay compared to those who received vertical midline incision (mean±SD: 18.0±4.8 days vs. 21.7±3.7 days,
p＜0.042). There was no difference in the number of dissected pelvic lymph nodes, hemoglobin change, postoperative
pain, postoperative ileus, Foley indwelling duration, and perioperative complications.
Conclusion: Excluding the selection bias for age, there was no significant difference of the clinical outcome between
the modified Cherney incision group and the vertical midline incision group. Modified Cherney incision can be
cosmetically performed in young age women obtaining equal number of lymph nodes without increased operative
morbidity compared to vertical midline incision.

참고문헌 (Reference)

1 박재묵, "자궁경부암 환자에 있어서 근치자궁절제술 및 골반림프절 절제술에 대한 Pfannenstiel incision과 Vertical midline incision의 비교" 대한산부인과학회 46 (46): 2441-2445, 2003

2 Gleeson NC, "modification of the Cherney incision in gynaecological oncology surgery" 102 : 925-926, 1995

3 Tobin GR, "Vaginal and pelvic reconstruction with distally based rectus abdominis myocutaneous flaps" 81 : 62-73, 1988

4 Helmkamp BF, "The Maylard incision in gynecologic surgery" 163 : 1554-1557, 1990

5 Trott E, "The Cherney incision for removal of a large pelvic mass: A case report" 66 : 213-215, 1994

6 Orr JW Jr, "Radical hysterectomy: Does the type of incision matter?" 173 : 399-405, 1995

7 Berek JS, "Practical gynecologic oncology" William & Wilkins 249-, 1994

8 Mann WJ Jr, "Perioperative influences on infectious morbidity in radical hysterectomy" 11 : 207-212, 1981

9 Cherney LS, "New transverse low abdominal incision" 59 : 215-218, 1943

10 Choi HJ, "Comparison of the accuracy of magnetic resonance imaging and positron emission tomography/computed tomography in the presurgical detection of lymph node metastases in patients with uterine cervical carcinoma: A prospective study" 106 : 914-922, 2006

11 Photopulos GJ, "Class II radical hysterectomy shows less morbidity and good treatment efficacy compared to class III" 40 : 21-24, 1991

12 De Lia JE, "Cherney versus midline vertical incision for myomectomy or hysterectomy of a significantly enlarged uterus" 173 : 1714-1717, 1995

13 Jemal A, "Cancer statistics, 2007" 57 : 43-66, 2007

14 Delgado G, "A prospective surgical pathological study of stage I squamous carcinoma of the cervix: A Gynecologic Oncology Group Study" 35 : 314-320, 1989

15 Burch JC, "A clinical evaluation of Cherney's incision" 127 : 830-835, 1948