Parietal seeding of carcinoma of the gallbladder after laparoscopic cholecystectomy

Abstract

We agree with Mr Widdison's comment that perineal drains can be brought out more anteriorly with a consequent reduction in postoperative discomfort of group 2 patients (undergoing primary closure of the perineum and perineal drainage).With respect to the comments of Lewis et al., our results show a longer postoperative hospital stay for group 2 patients than in their series.We do not know their rate of infection but our patients had a high rate of perineal wound infection (47 per cent) with method 2, which made partial or complete opening of the perineal wound necessary.This led to a longer hospital stay.Our patients were not randomized, although the study was done prospectively, requiring that the three series be homogeneous with respect to age, sex and histological degree of malignancy.A non-parametric test could be used for the differences in hospital stay but the statistical test used is robust and the conclusions identical with either method.