Comparing the effects of intercostal and subcostal flank incision on post-operative pain and incisional hernia or bulge in patients undergoing open kidney surgery: A randomized clinical trial

BACKGROUND: Flank incision, a common approach in kidney surgery, has several types. This study was carried out to examine the effect of using subcostal and intercostal flank incisions on post-operative pain, incisional hernia or bulging, and incision time and wound closure time in patients undergoin...

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Main Authors: Alireza Abdi, Behzad Imani, Seyed Habibollah Mousavibahar, Salman Khazaei, Shima Bahrami Jalal
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2024-12-01
Series:International Journal of Abdominal Wall and Hernia Surgery
Subjects:
Online Access:https://doi.org/10.4103/ijawhs.ijawhs_59_24
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author Alireza Abdi
Behzad Imani
Seyed Habibollah Mousavibahar
Salman Khazaei
Shima Bahrami Jalal
author_facet Alireza Abdi
Behzad Imani
Seyed Habibollah Mousavibahar
Salman Khazaei
Shima Bahrami Jalal
author_sort Alireza Abdi
collection DOAJ
description BACKGROUND: Flank incision, a common approach in kidney surgery, has several types. This study was carried out to examine the effect of using subcostal and intercostal flank incisions on post-operative pain, incisional hernia or bulging, and incision time and wound closure time in patients undergoing open kidney surgery. MATERIALS AND METHODS: This randomized clinical trial was conducted Iran (2023–2024). Sixty-four patients were randomly divided into two groups of 32 patients, subcostal and intercostal, based on available sampling technique. The Visual Analog Scale was used to assess post-operative pain. The abdominal wall asymmetry (AWA) technique was used for both hernia and bulge, and clinical examination was done by a urology surgeon for diagnosing AWA. Data analysis was done using SPSS-23. RESULTS: In the subcostal group, a higher incidence of AWA was observed when compared to the intercostal group at 6 months post-operation, and this difference was statistically significant (P = 0.039). However, there was no significant difference between the two groups at 3 months post-operation in this regard (P > 0.05). The mean pain score of patients at 24 and 72 h post-operation was significantly higher in the intercostal group than in the subcostal group (P < 0.05); however, at the first hour and on day 7 post-surgery, no significant difference was found between the two groups in this regard (P > 0.05). In addition, no significant differences existed between the two groups regarding incision time and wound closure time (P > 0.05). CONCLUSION: Intercostal incision, when compared to subcostal incision, was associated with lower probability of development of hernia or bulge, in spite of its higher-level post-operative pain. TRIAL REGISTRATION: This study was registered with the Iranian Clinical Trials Registry under the code IRCT20230208057358N1 on 2023.02.11.
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series International Journal of Abdominal Wall and Hernia Surgery
spelling doaj-art-a6b5d97880384874a23c62c9152f1d5b2025-01-17T10:51:27ZengWolters Kluwer Medknow PublicationsInternational Journal of Abdominal Wall and Hernia Surgery2589-87362589-80782024-12-017416517010.4103/ijawhs.ijawhs_59_24Comparing the effects of intercostal and subcostal flank incision on post-operative pain and incisional hernia or bulge in patients undergoing open kidney surgery: A randomized clinical trialAlireza AbdiBehzad ImaniSeyed Habibollah MousavibaharSalman KhazaeiShima Bahrami JalalBACKGROUND: Flank incision, a common approach in kidney surgery, has several types. This study was carried out to examine the effect of using subcostal and intercostal flank incisions on post-operative pain, incisional hernia or bulging, and incision time and wound closure time in patients undergoing open kidney surgery. MATERIALS AND METHODS: This randomized clinical trial was conducted Iran (2023–2024). Sixty-four patients were randomly divided into two groups of 32 patients, subcostal and intercostal, based on available sampling technique. The Visual Analog Scale was used to assess post-operative pain. The abdominal wall asymmetry (AWA) technique was used for both hernia and bulge, and clinical examination was done by a urology surgeon for diagnosing AWA. Data analysis was done using SPSS-23. RESULTS: In the subcostal group, a higher incidence of AWA was observed when compared to the intercostal group at 6 months post-operation, and this difference was statistically significant (P = 0.039). However, there was no significant difference between the two groups at 3 months post-operation in this regard (P > 0.05). The mean pain score of patients at 24 and 72 h post-operation was significantly higher in the intercostal group than in the subcostal group (P < 0.05); however, at the first hour and on day 7 post-surgery, no significant difference was found between the two groups in this regard (P > 0.05). In addition, no significant differences existed between the two groups regarding incision time and wound closure time (P > 0.05). CONCLUSION: Intercostal incision, when compared to subcostal incision, was associated with lower probability of development of hernia or bulge, in spite of its higher-level post-operative pain. TRIAL REGISTRATION: This study was registered with the Iranian Clinical Trials Registry under the code IRCT20230208057358N1 on 2023.02.11.https://doi.org/10.4103/ijawhs.ijawhs_59_24flank incisionherniaincisional herniaintercostal incisionopen kidney surgerysubcostal incision
spellingShingle Alireza Abdi
Behzad Imani
Seyed Habibollah Mousavibahar
Salman Khazaei
Shima Bahrami Jalal
Comparing the effects of intercostal and subcostal flank incision on post-operative pain and incisional hernia or bulge in patients undergoing open kidney surgery: A randomized clinical trial
International Journal of Abdominal Wall and Hernia Surgery
flank incision
hernia
incisional hernia
intercostal incision
open kidney surgery
subcostal incision
title Comparing the effects of intercostal and subcostal flank incision on post-operative pain and incisional hernia or bulge in patients undergoing open kidney surgery: A randomized clinical trial
title_full Comparing the effects of intercostal and subcostal flank incision on post-operative pain and incisional hernia or bulge in patients undergoing open kidney surgery: A randomized clinical trial
title_fullStr Comparing the effects of intercostal and subcostal flank incision on post-operative pain and incisional hernia or bulge in patients undergoing open kidney surgery: A randomized clinical trial
title_full_unstemmed Comparing the effects of intercostal and subcostal flank incision on post-operative pain and incisional hernia or bulge in patients undergoing open kidney surgery: A randomized clinical trial
title_short Comparing the effects of intercostal and subcostal flank incision on post-operative pain and incisional hernia or bulge in patients undergoing open kidney surgery: A randomized clinical trial
title_sort comparing the effects of intercostal and subcostal flank incision on post operative pain and incisional hernia or bulge in patients undergoing open kidney surgery a randomized clinical trial
topic flank incision
hernia
incisional hernia
intercostal incision
open kidney surgery
subcostal incision
url https://doi.org/10.4103/ijawhs.ijawhs_59_24
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