Abstract
Background
The aim of this study was to evaluate various clinical parameters that would influence the occurrence of wound infection (WI) in elective laparoscopic surgery (LS) for colorectal carcinoma.
Methods
The study included 290 patients who underwent LS between June 2001 and December 2005. WI was diagnosed within 30 days of the operation, and both superficial and deep incision surgical site infection were evaluated together.
Results
Eighteen (6.2%) were diagnosed with WI. Of the infected patients, nine (50%) had WI at the extraction site, six (33%) at the port site of the drainage tube, and three (17%) at the supraumbilical incision. Following bivariate analysis, the variables of stoma creation, intraoperative hypotension, and length of operation were selected for multivariate analysis as their P values were <0.2, the predominant cutoff, and stoma creation and intraoperative hypotension were independently predictive of developing WI. Regarding the duration of postoperative hospital stay, there was no significant difference between patients with or without WI.
Conclusions
Stoma creation and intraoperative hypotension were independent risk factors for WI. The results obtained in this study should be considered in an effort to prevent WI in LS for colorectal carcinoma, although these risk factors need further evaluation.
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References
Abraham NS, Young JM, Solomon MJ (2004) Meta-analysis of short-term outcomes after laparoscopic resection for colorectal cancer. Br J Surg 91: 1111–1124
Braga M, Vignali A, Zuliani W, Frasson M, Di Serio C, Di Carlo V (2005) Laparoscopic versus open colorectal surgery: cost-benefit analysis in a single-center randomized trial. Ann Surg 242: 890–896
Bucher P, Gervaz P, Soravia C, Mermillod B, Erne M, Morel P (2005) Randomized clinical trial of mechanical bowel preparation versus no preparation before elective left-sided colorectal surgery. Br J Surg 92: 409–414
Clinical Outcomes of Surgical Therapy Study Group. (2004) A comparison of laparoscopically assisted and open colectomy for colon cancer. N Engl J Med 350: 2050–2059
Espin-Basany E, Sanchez-Garcia JL, Lopez-Cano M, Lozoya-Trujillo R, Medarde-Ferrer M, Armadans-Gil L, Alemany-Vilches L, Armengol-Carrasco M (2005) Prospective, randomized study on antibiotic prophylaxis in colorectal surgery. Is it really necessary to use oral antibiotics? Int J Colorectal Dis 20: 542–546
Gaynes RP, Culver DH, Horan TC, Edwards JR, Richards C, Tolson JS (2001) National Nosocominal Infections Surveillance System. Surgical site infection (SSI) rates in the United States, 1992–1998: the National Nosocomial Infections Surveillance System basic SSI risk index. Clin Infect Dis 33: S69–77
Guillou PJ, Quirke P, Thorpe H, Walker J, Jayne DG, Smith AM, Heath RM, Brown JM MRC CLASICC trial group. (2005) Short-term endpoints of conventional versus laparoscopic-assisted surgery in patients with colorectal cancer (MRC CLASICC trial): multicentre, randomised controlled trial. Lancet 365:1718–1726
Hasegawa H, Kabeshima Y, Watanabe M, Yamamoto S, Kitajima M (2003) Randomized controlled trial of laparoscopic versus open colectomy for advanced colorectal cancer. Surg Endosc 17: 636–640
Horan TC, Gaynes RP, Martone WJ, Jarvis WR, Emori TG (1992) CDC definitions of nosocomial surgical site infections, 1992: a modification of CDC definitions of surgical wound infections. Infect Control Hosp Epidemiol 13: 606–608
Kercher KW, Nguyen TH, Harold KL, Poplin ME, Matthews BD, Sing RF, Heniford BT (2004) Plastic wound protectors do not affect wound infection rates following laparoscopic-assisted colectomy. Surg Endosc 18: 148–151
Konishi T, Watanabe T, Kishimoto J, Nagawa H (2006) Elective colon and rectal surgery differ in risk factors for wound infection: results of prospective surveillance. Ann Surg 244: 758–763
Lacy AM, Garcia-Valdecasas JC, Delgado S, Castells A, Taura P, Piqué JM, Visa J (2002) Laparoscopy-assisted colectomy versus open colectomy for treatment of non-metastatic colon cancer: a randomised trial. Lancet 359: 2224–2229
Leung KL, Kwok SPY, Lam SCW, Lee JFY, Yiu RYC, Ng SSM, Lai PBS, Lau WY (2004) Laparoscopic resection of rectosigmoid carcinoma: prospective randomised trial. Lancet 363: 1187–1192
Mangram AJ, Horan TC, Pearson ML, silver LC, Jarvis WR (1999) The Hospital Infection Control Practices Advisory Committee. Guideline for prevention of surgical site infection, 1999. Hospital Infection Control Practices Advisory Committee. Infect Control Hosp Epidemiol 20: 250–278
Owens WD, Felts JA, Spitznagel EL Jr. (1978) ASA physical status classifications: a study of consistency of ratings. Anesthesiology 49: 239–243
Slim K, Vicaut E, Panis Y, Chipponi J (2004) Meta-analysis of randomized clinical trials of colorectal surgery with or without mechanical bowel preparation. Br J Surg 91: 1125–1130
Smith RL, Bohl JK, McElearney ST, Friel CM, Barclay MM, Sawyer RG, Foley EF (2004) Wound infection after elective colorectal resection. Ann Surg 239: 599–607
Sørensen LT, Hemmingsen U, Kallehave F, Wille-Jørgensen P, Kjaergaard J, Møller LN, Jørgensen T (2005) Risk factors for tissue and wound complications in gastrointestinal surgery. Ann Surg 241: 654–658
Tang CL, Eu KW, Tai BC, Soh JG, MacHin D, Seow-Choen F (2001) Randomized clinical trial of the effect of open versus laparoscopically assisted colectomy on systemic immunity in patients with colorectal cancer. Br J Surg 88: 801–807
Tang R, Chen H, WangY, Changchien C, Chen JS, MD, Hsu KC, Chiang JM, Wang JY (2001) Risk factors for surgical site infection after elective resection of the colon and rectum: a single-center prospective study of 2,809 consecutive patients. Ann Surg 234: 181–189
Urbach DR, Kennedy ED, Cohen MM (1999) Colon and rectal anastomoses do not require routine drainage: a systematic review and meta-analysis. Ann Surg 229: 174–180
Weiss CA 3rd, Statz CL, Dahms RA, Remucal MJ, Dunn DL, Beilman GJ (1999) Six years of surgical wound infection surveillance at a tertiary care center: review of the microbiologic and epidemiological aspects of 20,007 wounds. Arch Surg 134: 1041–1048
Winslow ER, Fleshman JW, Birnbaum EH, Brunt LM (2002) Wound complications of laparoscopic vs open colectomy. Surg Endosc 16: 1420–1425
Wren SM, Ahmed N, Jamal A, Safadi BY (2005) Preoperative oral antibiotics in colorectal surgery increase the rate of Clostridium difficile colitis. Arch Surg 140: 752–756
Wu FP, Sietses C, von Blomberg BM, van Leeuwen PA, Meijer S, Cuesta MA (2003) Systemic and peritoneal inflammatory response after laparoscopic or conventional colon resection in cancer patients: a prospective, randomized trial. Dis Colon Rectum 46: 147–155
Yamamoto S, Fujita S, Akasu T, Moriya Y (2004) A comparison of the complication rates between laparoscopic colectomy and laparoscopic low anterior resection. Surg Endosc 18: 1447–1451
Yamamoto S, Fujita S, Akasu T, Moriya Y (2005) Safety of laparoscopic intracorporeal rectal transection with double-stapling technique anastomosis. Surg Laparosc Endosc Percutan Tech 15:70–74
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Yamamoto, S., Fujita, S., Akasu, T. et al. Wound infection after elective laparoscopic surgery for colorectal carcinoma. Surg Endosc 21, 2248–2252 (2007). https://doi.org/10.1007/s00464-007-9358-x
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DOI: https://doi.org/10.1007/s00464-007-9358-x