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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...

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Autores principales: 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
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
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.
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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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