Luigi Frigerio

J.Pelvic Surg., 2, 5, 239-244, 1996
( In Coll. con A.Ferrari,M.Origoni,G.Candotti,A.Mariani,M.Petrone )
Summary: Aim of the surgery is not only the resolution of the pathologic conditions, but also the reduction of complications. Cearean section, more than other operations, has not undergone significant modifications for a very long time. The Stark procedure, based on anatomical principles and the elimination of unnecessary surgical steps, is presented as an alternative to the traditional tecnique of cesarean section. In this study, the surgical outcome of 57 patiens who underwent a modified Stark procedure was compared with 57 traditional Cesarean sections. Total operating time, fetal extraction time, surgical material consumption, maternal blood loss, postoperative febrile morbidity, and recovery were compared in both groups and statistically analyzed. Mean extraction time of the fetus in the modified Stark procedure was 3.1 minutes (range 1-7), whereas in the traditional procedure it was 7.3 minutes (range 2-19, P<0.001). Mean total operating time was 17 minutes (range 11-28) in the Stark cases and 53.9 minutes (range 38-80) in the control group (P<0.001). Among the Stark cases, a mean of 3.5 threads was used (range 3-6), whereas in the control group the mean was 9.2 (range 6-19, p<0.001). Maternal blood loss, postoperative febrile morbidity, and recovery were significantly improved in the group submitted to the modified Stark procedure. The basic concept of this innovative tecnique is the elimination of unnecessary surgical steps and introduction of an alternative approach to the pelvis. The results of this study indicate significant reduction of morbidity and improved outcome.