Parietal peritoneal closure and persistent postcesarean pain

Shahin, Ahmed Y.; Osman, Ayman Mamdouh

doi:10.1016/j.ijgo.2008.09.012

Cited by 40 publications

(24 citation statements)

References 23 publications

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“…Since this review was published, a further fi ve trials have been published. 9,[19][20][21][22] Four of these trials are moderate in size (between 80 and 340 women per trial), [19][20][21][22] whereas the CAESAR trial included 2995 women in this comparison. 9 Some of the smaller trials found similar fi ndings to the Cochrane review, with shorter operating times and less postoperative febrile morbidity in the non-closure group.…”

Section: Discussionmentioning

confidence: 99%

Caesarean section surgical techniques (CORONIS): a fractional, factorial, unmasked, randomised controlled trial

Ábalos¹,

et al. 2013

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SummaryBackground Variations exist in the surgical techniques used for caesarean section and many have not been rigorously assessed in randomised controlled trials. We aimed to assess whether any surgical techniques were associated with improved outcomes for women and babies.Methods CORONIS was a pragmatic international 2×2×2×2×2 non-regular fractional, factorial, unmasked, randomised controlled trial that examined fi ve elements of the caesarean section technique in intervention pairs. CORONIS was undertaken at 19 sites in Argentina, Chile, Ghana, India, Kenya, Pakistan, and Sudan. Each site was assigned to three of the fi ve intervention pairs: blunt versus sharp abdominal entry; exteriorisation of the uterus for repair versus intraabdominal repair; single-layer versus double-layer closure of the uterus; closure versus non-closure of the peritoneum (pelvic and parietal); and chromic catgut versus polyglactin-910 for uterine repair. Pregnant women were eligible if they were to undergo their fi rst or second caesarean section through a planned transverse abdominal incision. Women were randomly assigned by a secure web-based number allocation system to one intervention from each of the three assigned pairs. All investigators, surgeons, and participants were unmasked to treatment allocation. The primary outcome was the composite of death, maternal infectious morbidity, further operative procedures, or blood transfusion (>1 unit) up to the 6-week follow-up visit. Women were analysed in the groups into which they were allocated. The CORONIS Trial is registered with Current Controlled Trials: ISRCTN31089967. Interpretation These fi ndings suggest that any of these surgical techniques is acceptable. However, longer-term follow-up is needed to assess whether the absence of evidence of short-term eff ects will translate into an absence of long-term eff ects.Funding UK Medical Research Council and WHO.

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Section: Discussionmentioning

confidence: 99%

Caesarean section surgical techniques (CORONIS): a fractional, factorial, unmasked, randomised controlled trial

Ábalos¹,

et al. 2013

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“…Demirel et al reported that postoperative pain was found higher in the closure group than the nonclosure group in women undergoing gynecological abdominal surgery [17]. Similar results were found in women undergoing cesarean section [18]. Moreover, Woyton et al reported that nonclosure of the visceral peritoneum during abdominal gynecological surgery decreased the incidence of adhesions and could prevent dislocation or ligation of the ureter [19].…”

Section: Discussionmentioning

confidence: 85%

Non-closure of the peritoneum and subcutaneous tissue at radical hysterectomy: A randomized controlled trial

Xiong

Wang

2010

Front. Med. China

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We conducted a trial to assess the influence of closure or nonclosure of the peritoneum and subcutaneous tissue on the clinical outcomes of cervical cancer patients who underwent radical hysterectomy with lower abdominal cross incision. This randomized controlled trial was performed on 158 cervical cancer patients in our hospital between January 2002 and June 2004. Eighty-two patients were allocated to the "closure" group and 76 patients to the "nonclosure" group. Results showed that non-closure of the peritoneum and subcutaneous tissue could shorten operation time and febrile duration, reduce antibiotics requirement, increase the volume of drainage and decrease the incidence of liquefaction of subcutaneous fat (P < 0.05). There was no difference in blood loss, postoperative complications, bowel function restoration and post-operative stay between the two groups (P > 0.05). Our study revealed that closure of the peritoneum and subcutaneous tissue provides no immediate postoperative benefits while unnecessarily lengthening surgical time and anesthesia exposure. The practice of closure of the peritoneum and subcutaneous tissue at radical hysterectomy should be questioned.

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“…Après randomisation d'un groupe de 340 césariennes électives, les résultats étaient en faveur d'une incidence significativement plus élevée de la douleur postopératoire précoce et persistante après péritonisation pariétale et qu'un score de la douleur élevée au premier jour prédit la persistance de la douleur à long terme [17].…”

Section: Discussionunclassified

Vers une simplification de la technique de césarienne : suture péritonéale ou non ?

Malek-Mellouli

Ibrahima

Amara

et al. 2011

Journal de Gynécologie Obstétrique et Biologie de la Reproducti

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Parietal peritoneal closure and persistent postcesarean pain

Abstract: Parietal peritoneal closure after cesarean delivery is associated with a higher incidence of early and persistent postoperative pain. A high pain score on the 1st day is a predictor of persistent pain.

Cited by 40 publications

References 23 publications

Caesarean section surgical techniques (CORONIS): a fractional, factorial, unmasked, randomised controlled trial

Caesarean section surgical techniques (CORONIS): a fractional, factorial, unmasked, randomised controlled trial

Non-closure of the peritoneum and subcutaneous tissue at radical hysterectomy: A randomized controlled trial

Vers une simplification de la technique de césarienne : suture péritonéale ou non ?

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