Luigi Frigerio

It.J.Gynecol.Obstet. 3: 95-102,1997
( in coll. con A.G.Ferrari, G.Candotti, M.Origoni, A.Mariani, M.Petrone )
Summary: We asses the validity of a modified Stark procedure for caesarean section, based on anatomical principles of the elimination of unnecessary surgical steps. The surgical outcome of 127 cases submitted to this procedure was compared to 95 traditional caesarean sections. We analysed total operating time, fetal extraction time, surgical material consumption, maternal blood loss, postoperative febbrile morbidity and recovery in both groups. Mean total operating time was 19.4 min (range 11-28) in the Stark cases and 51.7 min (33-80) in the control group (p <0.001). Fetal extaction time was also reduced in the Stark technique: mean time was 3.2 min (range 1-7), while in the traditional procedure it was 6.5 min (range 2-18) (p <0.001). Among the Stark cases a mean of 3.5 threads was used (range 3-6), while in the control group 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 theoretical background of the innovative Stark procedure seems to be confirmed by our results: the Stark procedure is associated with a significant reduction of morbidity and an improve outcome.