Transumbilical abdominal incision for laparoscopic colorectal surgery does not increase the risk of postoperative surgical site infection
Transumbilical abdominal incision for laparoscopic colorectal surgery does not increase the risk of postoperative surgical site infection
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腹腔镜结直肠手术经脐腹部切口不会增加术后手术部位感染的风险
DOI：
10.1007/s00384-017-2753-4
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发表时间：
2017
影响因子：
2.8
通讯作者：
Sasaki Akira
中科院分区：
文献类型：
--
作者：
Yaegashi Mizunori;Otsuka Koki;Kimura Toshimoto;Hakozaki Masanori;Kamishima Megumu;Hatanaka Tomoki;Sato Kei;Fujii Hitoshi;Matsuo Teppei;Sasaki Akira
摘要目的除抗生素预防外，无菌备皮是预防手术部位感染（SSI）的重要措施。没有报告详细的SSI和脐微生物菌群之间的关系，腹腔镜下结直肠癌transsummarian纵向incidence.MethodsRisk factors和SSI的发生率进行了调查，在453例患者接受腹腔镜结直肠切除术超过3年的时间。从脐和SSI areas.ResultsAfter腹腔镜手术，我们观察到SSI在大约5%的情况下，浅表SSI在15例（3.3%）患者和器官/空间SSI 7（1.5%）。在单因素分析中，术前白蛋白（Alb）值和肠结肠吻合术的吻合与浅表SSI的发生显著相关。此外，年龄、失血量、造口、肿瘤部位（直肠）和Hartmann/腹部会阴切除术（APR）是器官/空间SSI的重要风险因素。在多变量分析中，术前Alb值是与浅表SSI易感性相关的最重要因素。SSI中检测到的细菌大多数与伤口闭合时的细菌不同。抗生素耐药菌包括在器官/空间SSI all cases.ConclusionsSSI的发展与腹腔镜手术据报道发生在约3-15%的情况下。本研究和其他报告中的SSI发生率相当。在采取足够的控制措施时，在腹腔镜结直肠手术中使用小的经脐纵切口不太可能引起SSI，即使脐部含有大量的常驻细菌。
AbstractPurposeBesides antibiotic prophylaxis, antiseptic skin preparation is an important measure to prevent surgical site infection (SSI). No reports have detailed the relationship between SSI and umbilical microflora following laparoscopic colorectal cancer with a transumbilical longitudinal incision.MethodsRisk factors and the rate of SSI were investigated in 453 patients who underwent laparoscopic colorectal resection over a 3-year period. Microbiological samples were collected from the umbilicus and SSI areas.ResultsAfter laparoscopic procedure, we observed SSIs in approximately 5% of cases, with superficial SSI in 15 (3.3%) patients and organ/space SSIs 7 (1.5%). In univariate analysis, preoperative albumin (Alb) value and anastomosis of enterocolostomy were significantly associated with superficial SSI development. Also, age, blood loss, stoma, tumor site (rectum), and Hartmann/abdominal perineal resection (APR) were significant risk factors for organ/space SSI. In multivariate analysis, the preoperative Alb value was the most significant factor associated with a predisposition to superficial SSI. The bacteria detected in SSI were mostly different from those at wound closure. Antibiotic-resistant bacteria were included in organ/space SSI all cases.ConclusionsSSI development with laparoscopic surgery reportedly occurs in about 3–15% cases. The SSI rate in this study and other reports was comparable. Using small transumbilical longitudinal incision in laparoscopic colorectal surgery is less likely to cause SSI when sufficient control measures are enacted, even though the umbilicus contains resident bacteria in abundance.