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Ability of minimally invasive surgery to decrease incisional surgical site infection occurrence in patients with colorectal cancer and other gastroenterological malignancies
BACKGROUND: Surgical site infection (SSI) is one of the most important complications of surgery for gastroenterological malignancies because it leads to a prolonged postoperative hospital stay and increased inpatient costs. Furthermore, SSI can delay the initiation of postoperative treatments, inclu...
Autores principales: | , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10130529/ https://www.ncbi.nlm.nih.gov/pubmed/37123540 http://dx.doi.org/10.3389/fsurg.2023.1150460 |
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author | Yamamoto, Takehito Yoshitomi, Mami Oshimo, Yoshiki Nishikawa, Yuta Hisano, Koji Nakano, Kenzo Kawai, Takayuki Okuchi, Yoshihisa Iguchi, Kohta Tanaka, Eiji Fukuda, Meiki Taura, Kojiro Terajima, Hiroaki |
author_facet | Yamamoto, Takehito Yoshitomi, Mami Oshimo, Yoshiki Nishikawa, Yuta Hisano, Koji Nakano, Kenzo Kawai, Takayuki Okuchi, Yoshihisa Iguchi, Kohta Tanaka, Eiji Fukuda, Meiki Taura, Kojiro Terajima, Hiroaki |
author_sort | Yamamoto, Takehito |
collection | PubMed |
description | BACKGROUND: Surgical site infection (SSI) is one of the most important complications of surgery for gastroenterological malignancies because it leads to a prolonged postoperative hospital stay and increased inpatient costs. Furthermore, SSI can delay the initiation of postoperative treatments, including adjuvant chemotherapy, negatively affecting patient prognosis. Identifying the risk factors for SSI is important to improving intra- and postoperative wound management for at-risk patients. METHODS: Patients with gastroenterological malignancies who underwent surgery at our institution were retrospectively reviewed and categorized according to the presence or absence of incisional SSI. Clinicopathological characteristics such as age, sex, body mass index, malignancy location, postoperative blood examination results, operation time, and blood loss volume were compared between groups. The same analysis was repeated of only patients with colorectal malignancies. RESULTS: A total of 528 patients (330 men, 198 women; mean age, 68 ± 11 years at surgery) were enrolled. The number of patients with diseases of the esophagus, stomach, small intestine, colon and rectum, liver, gallbladder, and pancreas were 25, 150, seven, 255, 51, five, and 35, respectively. Open surgery was performed in 303 patients vs. laparoscopic surgery in 225 patients. An incisional SSI occurred in 46 patients (8.7%). Multivariate logistic regression analysis showed that postoperative hyperglycemia (serum glucose level ≥140 mg/dl within 24 h after surgery), colorectal malignancy, and open surgery were independent risk factors for incisional SSI. In a subgroup analysis of patients with colorectal malignancy, incisional SSI occurred in 27 (11%) patients. Open surgery was significantly correlated with the occurrence of incisional SSI (P = 0.024). CONCLUSIONS: Postoperative hyperglycemia and open surgery were significant risk factors for SSI in patients with gastroenterological malignancies. Minimally invasive surgery could reduce the occurrence of incisional SSI. |
format | Online Article Text |
id | pubmed-10130529 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-101305292023-04-27 Ability of minimally invasive surgery to decrease incisional surgical site infection occurrence in patients with colorectal cancer and other gastroenterological malignancies Yamamoto, Takehito Yoshitomi, Mami Oshimo, Yoshiki Nishikawa, Yuta Hisano, Koji Nakano, Kenzo Kawai, Takayuki Okuchi, Yoshihisa Iguchi, Kohta Tanaka, Eiji Fukuda, Meiki Taura, Kojiro Terajima, Hiroaki Front Surg Surgery BACKGROUND: Surgical site infection (SSI) is one of the most important complications of surgery for gastroenterological malignancies because it leads to a prolonged postoperative hospital stay and increased inpatient costs. Furthermore, SSI can delay the initiation of postoperative treatments, including adjuvant chemotherapy, negatively affecting patient prognosis. Identifying the risk factors for SSI is important to improving intra- and postoperative wound management for at-risk patients. METHODS: Patients with gastroenterological malignancies who underwent surgery at our institution were retrospectively reviewed and categorized according to the presence or absence of incisional SSI. Clinicopathological characteristics such as age, sex, body mass index, malignancy location, postoperative blood examination results, operation time, and blood loss volume were compared between groups. The same analysis was repeated of only patients with colorectal malignancies. RESULTS: A total of 528 patients (330 men, 198 women; mean age, 68 ± 11 years at surgery) were enrolled. The number of patients with diseases of the esophagus, stomach, small intestine, colon and rectum, liver, gallbladder, and pancreas were 25, 150, seven, 255, 51, five, and 35, respectively. Open surgery was performed in 303 patients vs. laparoscopic surgery in 225 patients. An incisional SSI occurred in 46 patients (8.7%). Multivariate logistic regression analysis showed that postoperative hyperglycemia (serum glucose level ≥140 mg/dl within 24 h after surgery), colorectal malignancy, and open surgery were independent risk factors for incisional SSI. In a subgroup analysis of patients with colorectal malignancy, incisional SSI occurred in 27 (11%) patients. Open surgery was significantly correlated with the occurrence of incisional SSI (P = 0.024). CONCLUSIONS: Postoperative hyperglycemia and open surgery were significant risk factors for SSI in patients with gastroenterological malignancies. Minimally invasive surgery could reduce the occurrence of incisional SSI. Frontiers Media S.A. 2023-04-12 /pmc/articles/PMC10130529/ /pubmed/37123540 http://dx.doi.org/10.3389/fsurg.2023.1150460 Text en © 2023 Yamamoto, Yoshitomi, Oshimo, Nishikawa, Hisano, Nakano, Kawai, Okuchi, Iguchi, Tanaka, Fukuda, Taura and Terajima. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) (https://creativecommons.org/licenses/by/4.0/) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Surgery Yamamoto, Takehito Yoshitomi, Mami Oshimo, Yoshiki Nishikawa, Yuta Hisano, Koji Nakano, Kenzo Kawai, Takayuki Okuchi, Yoshihisa Iguchi, Kohta Tanaka, Eiji Fukuda, Meiki Taura, Kojiro Terajima, Hiroaki Ability of minimally invasive surgery to decrease incisional surgical site infection occurrence in patients with colorectal cancer and other gastroenterological malignancies |
title | Ability of minimally invasive surgery to decrease incisional surgical site infection occurrence in patients with colorectal cancer and other gastroenterological malignancies |
title_full | Ability of minimally invasive surgery to decrease incisional surgical site infection occurrence in patients with colorectal cancer and other gastroenterological malignancies |
title_fullStr | Ability of minimally invasive surgery to decrease incisional surgical site infection occurrence in patients with colorectal cancer and other gastroenterological malignancies |
title_full_unstemmed | Ability of minimally invasive surgery to decrease incisional surgical site infection occurrence in patients with colorectal cancer and other gastroenterological malignancies |
title_short | Ability of minimally invasive surgery to decrease incisional surgical site infection occurrence in patients with colorectal cancer and other gastroenterological malignancies |
title_sort | ability of minimally invasive surgery to decrease incisional surgical site infection occurrence in patients with colorectal cancer and other gastroenterological malignancies |
topic | Surgery |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10130529/ https://www.ncbi.nlm.nih.gov/pubmed/37123540 http://dx.doi.org/10.3389/fsurg.2023.1150460 |
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