Effect of perioperative oral management on the prevention of surgical site infection after colorectal cancer surgery
Effect of perioperative oral management on the prevention of surgical site infection after colorectal cancer surgery
复制标题
围手术期口腔管理对预防结直肠癌术后手术部位感染的影响
作者：
H. Nobuhara;S. Yanamoto;M. Funahara;Y. Matsugu;S. Hayashida;S. Soutome;A. Kawakita;S. Ikeda;T. Itamoto;M. Umeda
摘要手术部位感染（SSI）是结直肠癌术后常见的并发症之一。据报道，口腔保健可以降低口腔、食管癌和肺癌手术中SSI或术后肺炎的风险。本研究的目的是探讨围手术期口腔管理对大肠癌术后SSI发生的预防作用。本文回顾了日本2家医院698例结直肠癌手术患者的病历。其中563例患者接受围手术期口腔管理（口腔管理组），135例患者未接受围手术期口腔管理（对照组）。调查了各种人口统计学、癌症相关和治疗相关的变量，包括围手术期口腔管理干预和SSI的发生。通过单因素和多因素分析，采用Fisher精确检验、单因素方差分析（ANOVA）和逻辑回归来检验各变量与SSI发生之间的关系。两组的SSI发生率通过逻辑回归进行评估，使用倾向评分作为协变量。采用Student’st检验分析口腔管理组与对照组术后平均住院时间的差异。698例患者中有68例（9.7%）发生SSI。多因素分析显示，手术时间、出血量、围手术期口腔管理与SSI的发生有显著相关。然而，经倾向评分分析，未接受围手术期口腔管理也成为SSI的重要危险因素。口服治疗组的优势比为0.484 （P = 0.014； 95%可信区间：0.272 ~ 0.862）。口腔治疗组术后平均住院时间明显短于对照组。围手术期口服管理可降低结直肠癌术后SSI的风险，缩短术后住院时间。
Abstract Surgical site infection (SSI) is 1 of the frequent postoperative complications after colorectal cancer surgery. Oral health care has been reported to reduce the risk of SSI or postoperative pneumonia in oral, esophageal, and lung cancer surgeries. The purpose of the study was to investigate the preventive effect of perioperative oral management on the development of SSI after a major colorectal cancer surgery. The medical records of 698 patients who underwent colorectal cancer surgery at 2 hospitals in Japan were reviewed. Among these patients, 563 patients received perioperative oral management (oral management group) and 135 did not (control group). Various demographic, cancer-related, and treatment-related variables including perioperative oral management intervention and the occurrence of SSI were investigated. The relationship between each variable and the occurrence of SSI was examined via univariate and multivariate analyses using Fisher exact test, 1-way analysis of variance (ANOVA), and logistic regression. The occurrence of SSI in the 2 groups was evaluated via logistic regression using propensity score as a covariate. The difference in mean postoperative hospital stay between the oral management and control groups was analyzed using Student's t test. SSI occurred in 68 (9.7%) of the 698 patients. Multivariate analysis showed that operation time, blood loss, and perioperative oral management were significantly correlated with the development of SSI. However, after the propensity score analysis, not receiving perioperative oral management also became a significant risk factor for SSI. The odds ratio of the oral management group was 0.484 (P = .014; 95% confidence interval: 0.272–0.862). Mean postoperative hospital stay was significantly shorter in the oral management group than in the control group. Perioperative oral management reduces the risk of SSI after colorectal cancer surgery and shortens postoperative hospital stay.
影响因子：
51.1
作者：
Michaud, Dominique S.;Liu, Yan;Joshipura, Kaumudi
通讯作者：
Joshipura, Kaumudi