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June 1964

Vertical vs Horizontal LaparotomiesI. Early Postoperative Comparisons

Arch Surg. 1964;88(6):911-914. doi:10.1001/archsurg.1964.01310240007003

There is an abundance of retrospective studies comparing vertical and transverse abdominal incisions, their postoperative complications, and the incidence of wound dehiscences and of incisional hernias.3,7,8,9,11 The evaluation of the sweeping conclusions often based on such studies must consider the unavoidable selection of patients in these series. Therefore, the need was felt to exist for an objective, prospective study, in which a randomized series of patients with vertical and transverse laparotomies might be compared. The present report pertains to the early follow-up of this series. Incisional hernia formation and postoperative intestinal obstruction will be reported on in two years' time.

Method and Technique  One hundred consecutive patients undergoing biliary operations (cholecystectomy without and with common bile duct exploration) constituted the series. General endotracheal anesthesia was used in all these patients, induced with pentothal, and maintained with cyclopropane or halothane (Fluothane). Succinylcholine was administered prior to intubation, and in minimal