The Maylard Incision in Gynecologic Surgery

Helmkamp, B. Frederick; Krebs, H B

doi:10.1097/00006254-199104000-00016

Cited by 8 publications

(12 citation statements)

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“…There are a number of papers which analyzed the advantages of the transverse incision over the midline incision in modified radical hysterectomy and pelvic lymph node dissection. Mann et al 7 , Photopolus et al 8 , and Helmkamp et al 9 reported that they performed either the Maylard or Cheney incision in 40 to 80% of modified radical hysterectomies and pelvic lymph node dissection. Orr et al 10 compared 113 cases of the vertical midline incision and 78 cases of transverse incision.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2008

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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.

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Section: Discussionmentioning

confidence: 99%

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

et al. 2008

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“…Photopolus y Helmkemp reportaron que 40-60% de sus histerectomías radicales fueron realizadas a través de laparotomías de Maylard o Cherney (11,12).…”

Section: Discussionunclassified

Incisiones Transversas en Oncología Ginecológica

G²,

O³

et al. 2007

Rev. chil. obstet. ginecol.

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RESUMENObjetivo: Determinar si el tipo de laparotomía influye en la etapificación de pacientes con cáncer de cuerpo y cuello uterino. Método: Se revisaron todas las fichas clínicas de pacientes con cáncer de cuerpo y cuello uterino que fueron operadas en el Hospital Clínico de la Universidad de Chile y el Hospital Clínico de la Fuerza Aérea Chilena, entre enero de 1999 y mayo de 2005. Se recopiló la siguiente información: tipo de laparotomía, índice de masa corporal (IMC), comorbilidades médicas, tiempo operatorio, histología, número total y distribución de linfonodos, pérdida sanguínea, complicaciones, duración de la cirugía y hospitalización. Se aplicaron análisis estadísticos con t student y χ 2 . Resultados: Se identificaron 51 pacientes. Se usó laparotomía media (LM) y transversa (LT) en 16 (31%) y 35 (69%) de las pacientes, respectivamente. No hubo diferencias significativas en índice de masa corporal, estadio FIGO, histología, comorbilidades, estimación de pérdida sanguínea ni complicaciones intra o post operatorias entre el grupo de LM y LT. Se encontraron diferencias significativas en pacientes con IMC ≥ 25 sometidas a laparotomías verticales comparadas con las transversas, donde ocurrió mayor sangrado intraoperatorio, se recolectó mayor número de ganglios para-aórticos y tuvieron hospitalizaciones más prolongadas. Conclusiones: La etapificación quirúrgica de pacientes con cáncer de cérvix o cuerpo uterino se puede realizar adecuadamente a través de incisiones transversas, sin mayor morbilidad. Previa adecuada selección, pacientes con cánceres cervical y uterino pueden beneficiarse de las ventajas ya descritas para las laparotomías transversas.PALABRAS CLAVES: Cáncer cervical, cáncer uterino, Pfannenstiel, Cherney, Maylard SUMMARY Objective: To determine if the type of abdominal incision influences the adequacy of surgical staging in patients with uterine and cervical cancer. Methods: A retrospective review of all uterine and cervical cancer patients operated on by the same surgeon at the Universidad de Chile Clinical Hospital and the Chilean Air Force Clinical Hospital between January 1, 1999, and May 1, 2005, is presented. Data on type of incision, body mass index (BMI), medical comorbilities, histology, total number and distribution of lymph nodes, estimated blood loss, complications, length of surgery and hospital stay were abstracted. Statistical analysis with two-tailed Student t test and χ 2 were performed. Results: 51 patients were identified. A vertical incision (VI) was used in 16 (31%) while 35 (69%) received a transverse incision (TI). There were no statistically significant differences in BMI, FIGO stage, histology, comorbilities, estimated blood loss or intraoperative and postoperative complications between the VI and TI groups. Compared patients with BMI ≥ 25, VI was Trabajos Originales

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“…Several types of low transverse incisions have been described: Pfannenstiel, transrectal Maylard, and Stark (4) . To perform a Pfannenstiel incision, the rectus sheath is freed from the underlying rectus abdominis muscles in a cranial direction up to the umbilicus and in a caudal direction to the pubic bone.…”

Section: Commentmentioning

confidence: 99%

“…As the Stark incision allows a quick access to the abdominal cavity and involves no reflection, this type of incision can be easily used for obstetric and gynecological benign surgery. The efficacy of the Maylard incision has also been illustrated in various gynecologic conditions including malignant disease, as it can be more easily extended to a ''J'' shape incision (4,9) . The latter incision should therefore be preferred in the case of a presumed benign adnexal mass whenever an open approach is chosen.…”

Section: Commentmentioning

confidence: 99%

Abdominal wall metastasis of ovarian carcinoma after low transverse abdominal incision: report of two cases and review of literature

Rafii

Ferron

Lacroix-Triki

et al. 2006

International Journal of Gynecological Cancer

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Occurrence of parietal metastases after surgery for a suspect adnexal mass may worsen the prognosis of the disease. However, it is not clear whether abdominal wall metastases is related to specific biologic features or simply to surgical mismanagement involving small incisions and traumatic extraction of the specimen, resulting in direct seeding of cancer cells. We report two cases with development of parietal dissemination of ovarian carcinomas after Pfannenstiel incision. The two patients needed parietal resection to obtain optimal surgical cytoreduction. Pfannenstiel incisions for exploration of suspicious adnexal masses increase the risk of extensive parietal metastasis in case of malignancy because they require reflection of several sheaths of tissue. The parietal extension of the disease may need major parietal resection that can worsen the functional and general outcome of the patients.

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The Maylard Incision in Gynecologic Surgery

Cited by 8 publications

References 0 publications

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

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

Incisiones Transversas en Oncología Ginecológica

Abdominal wall metastasis of ovarian carcinoma after low transverse abdominal incision: report of two cases and review of literature

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