The impact of parietal peritoneal closure on postoperative recovery following cesarean section: A prospective observational study

Sercan Kantarcı; Alaattin Karabulut; Didem Sezen; Uğurcan Dağlı; İlker Uçar; Pınar Tuğçe Özer; Meriç Balıkoğlu

doi:10.19161/etd.1772256

TR EN

Sezaryen keside parietal periton kapatılmasının postoperatif iyileşme üzerine etkisi: Prospektif gözlemsel çalışma

Öz

Amaç: Sezaryen doğum, obstetride en sık uygulanan cerrahi girişimlerden biridir. Postoperatif dönemde erken fonksiyonel iyileşmenin desteklenmesi, anne sağlığı ve sağlık hizmetlerinin etkinliği açısından kritik öneme sahiptir. Bu çalışma, sezaryende parietal periton kapatılmasının kısa dönem postoperatif iyileşme üzerindeki etkilerini araştırmayı amaçlamaktadır. Gereç ve Yöntem: Bu prospektif gözlemsel çalışmaya, 15 Ocak–15 Haziran 2025 tarihleri arasında spinal anestezi altında elektif koşullarda sezaryen uygulanan, 18–45 yaş aralığındaki kadınlar dahil edilmiştir. Acil sezaryenler, genel anestezi uygulananlar ve yüksek riskli gebelikler dışlanmıştır. Postoperatif iyileşme; EQ-5D Yaşam Kalitesi Ölçeği, Katz Günlük Yaşam Aktiviteleri İndeksi ve Obstetric Quality of Recovery (ObsQoR) skoru ile multidisipliner biçimde değerlendirilmiştir. Ayrıca ağrı skorları, gastrointestinal fonksiyonların geri dönüşü, ek analjezik gereksinimi ve hematolojik parametreler (NLR, PLR) karşılaştırılmıştır. Bulgular: Çalışmaya toplam 120 olgu alınmış olup, 60’ı periton kapatma, 60’ı kapatmama grubunda yer almıştır. Parietal periton kapatma grubunda postoperatif 5. günde EQ-5D skorları anlamlı düzeyde daha yüksek bulunmuştur (p < 0.05). Bunun dışında ağrı skorları, bağırsak fonksiyonlarının geri dönüşü, analjezik ihtiyacı ve hematolojik parametreler (NLR, PLR) açısından gruplar arasında istatistiksel olarak anlamlı fark saptanmamıştır. Sonuç: Bulgular, erken yaşama dönüş ve inflamatuvar belirteçler dikkate alındığında, rutin parietal periton kapatılmasının kısa dönem postoperatif iyileşmeye ek bir katkı sağlamadığını göstermektedir. Bu nedenle kapatma kararının rutin uygulamadan ziyade cerrahın tercihine ve klinik koşullara göre verilmesi daha uygun görünmektedir.

Anahtar Kelimeler

The impact of parietal peritoneal closure on postoperative recovery following cesarean section: A prospective observational study

Abstract

Aim: Caesarean section is one of the most frequently performed surgical procedures in obstetrics. Supporting early functional recovery in the postoperative period is of critical importance for maternal health and healthcare efficiency. This study aimed to investigate the short-term effects of parietal peritoneal closure on postoperative recovery following caesarean delivery. Materials and Methods: This prospective observational study included women aged 18–45 years who underwent elective caesarean section under spinal anesthesia between January 15 and June 15, 2025. Emergency cases, procedures performed under general anesthesia, and high-risk pregnancies were excluded. Postoperative recovery was evaluated multidimensionally using the EQ-5D Quality of Life Scale, the Katz Index of Independence in Activities of Daily Living, and the Obstetric Quality of Recovery (ObsQoR) score. Additional outcomes included pain scores, return of gastrointestinal function, requirement for additional analgesics, and hematological parameters (NLR, PLR). Results: A total of 120 women were enrolled, with 60 in the peritoneal closure group and 60 in the nonclosure group. On postoperative day 5, EQ-5D scores were significantly higher in the closure group (p < 0.05). No statistically significant differences were observed between groups in terms of pain intensity, gastrointestinal recovery, additional analgesic requirement, or hematological parameters (NLR, PLR). Conclusion: The findings suggest that routine parietal peritoneal closure does not provide additional benefits for short-term postoperative recovery when considering early return to daily activities and inflammatory markers. Therefore, the decision to close the peritoneum may be better guided by surgical preference and intraoperative conditions rather than routine practice.

Keywords

Supporting Institution

This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

Ethical Statement

This study was approved by the institutional ethics committee, and all procedures were conducted in accordance with the principles of the Declaration of Helsinki. Written informed consent was obtained from all participants included in the study.

Thanks

The authors declare that no acknowledgements are applicable, as no specific support or contribution was received for this study.

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Details

Primary Language

English

Subjects

Obstetrics and Gynaecology

Journal Section

Research Article

Authors

Sercan Kantarcı ^*
0000-0001-5608-060X
Türkiye

Alaattin Karabulut
0000-0002-0244-4401
Türkiye

Didem Sezen
0009-0007-6266-0185
Türkiye

Uğurcan Dağlı
0009-0006-3015-0909
Türkiye

İlker Uçar
0000-0002-4871-0621
Türkiye

Pınar Tuğçe Özer
0000-0002-3571-8894
Türkiye

Meriç Balıkoğlu
0000-0001-9689-814X
Türkiye

Publication Date

March 9, 2026

Submission Date

August 26, 2025

Acceptance Date

November 20, 2025

Published in Issue

Year 1970 Volume: 65 Number: 1

DOI

https://doi.org/10.19161/etd.1772256

IZ

https://izlik.org/JA23NG78JS

Cite

RIS / Bibtex

Vancouver

1.Sercan Kantarcı, Alaattin Karabulut, Didem Sezen, Uğurcan Dağlı, İlker Uçar, Pınar Tuğçe Özer, Meriç Balıkoğlu. The impact of parietal peritoneal closure on postoperative recovery following cesarean section: A prospective observational study. EJM. 2026 Mar. 1;65(1):99-106. doi:10.19161/etd.1772256