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Septic complications of elective laparoscopic colorectal resection

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Abstract

Background

We set out to determine the rate and pattern of septic complications of the surgical wound, abdominal cavity, and urinary and respiratory tracts following laparoscopic colorectal resection.

Methods

A longitudinal database of 500 consecutive cases of colorectal resections was reviewed.

Results

The total wound infection rate was 7.2% (36/500) and included infections of the abdominal wall wounds (32/500, 6.4%) and the perineal wounds (4/50, 8%). The anastomotic leak rate in 418 patients who underwent resection with primary anastomosis was 3.3% (14/418). Intraabdominal abscesses were diagnosed in 1% (5/500) of patients. Urinary tract infections were rare (3/500, 0.6%), as was postoperative pneumonia (6/500, 1%).

Conclusions

This study confirms the low rate of postoperative pneumonia observed with all other minimally invasive procedures. Intraabdominal abscesses, urinary tract infections, and postoperative pneumonia occur considerably less frequently than in reported historical controls for open surgery. The rates of abdominal wound infection and anastomotic leak in laparoscopic colorectal resection appear to be equivalent to traditional surgery, whereas the rate of perineal wound sepsis is lower. Comparative studies are needed to determine the differential costs of the septic episodes associated with the two approaches.

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References

  1. Baca I, Schultz C, Gotzen V, Grzybowski L (1997) Laparoskopishassistierte kolorektale chirurgie, fruhergebnisse bei gut-und bosartigen erkrankungen-eine prospektive untersuchung von 120 patienten. Zentralbl Chir 122: 569–576

    CAS  PubMed  Google Scholar 

  2. Baum ML, Anish DS, Chalmers TC, Sacks HS, Smith Jr H, Fagerstrom RM (1981) A survey of clinical trials of antibiotic prophylaxis in colon surgery: evidence against further use of no-treatment controls. N Engl J Med 305: 795–799

    Article  CAS  PubMed  Google Scholar 

  3. Breton G, Poulin E, Fortin C, Mamazza J, Robert J (1991) Clinical and haemodynamic evaluation of laparoscopic cholecystectomies [in French]. Ann Chir 45: 783–790

    CAS  PubMed  Google Scholar 

  4. Broader JH, Masselink BA, Oates GD, Alexander-Williams J (1974) Management of the pelvic space after proctectomy. Br J Surg 61: 94–97

    Article  CAS  PubMed  Google Scholar 

  5. Brune IB, Wilke W, Hensler T, Holzmann B, Siewert JR (1999) Downregulation of T helper type 1 immune response and altered proinflammatory and anti-inflammatory T cell cytokine balance following conventional but not laparoscopic surgery. Am J Surg 177: 55–59

    Article  CAS  PubMed  Google Scholar 

  6. Chapuis PH, Pheils MT, Dunn D, Bokey EL, Newland RC, Colquhoun K (1983) Mortality, morbidity and survival after colectomy for colon cancer. Aust N Z J Surg 53: 223–228

    Article  CAS  PubMed  Google Scholar 

  7. Denker H, Norryd C, Tranberg KG (1973) Management of the perineal wound after rectal excision. Acta Chir Scand 139: 568–570

    Google Scholar 

  8. Frazee RC, Roberts JW, Okeson GC, Symmonds RE, Snyder SK, Hendricks JC, Smith RW (1991) Open versus laparoscopic cholecystectomy: a comparison of postoperative pulmonary function. Ann Surg 214: 651–654

    Article  Google Scholar 

  9. Frazee RC, Roberts J, Symmonds R, Snyder S, Hendricks J, Smith R (1992) Prospective, randomized trial of inpatient vs. outpatient bowel preparation for elective colorectal surgery. Dis Colon Rectum 35: 223–226

    Article  CAS  PubMed  Google Scholar 

  10. Gagner M, Pomp A, Heniford BT, Pharand D, Lacroix A (1997) Laparoscopic adrenalectomy: lessons learned from 100 consecutive procedures. Ann Surg 226: 238–247

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  11. Jensen LS, Andersen A, Fristrup SC, Holme JB, Hvid HM, Kraglund K, Rasmussen PC, Toftgaard C (1990) Comparison of one dose versus three doses of prophylactic antibiotics, and the influence of blood transfusion, on infectious complications in acute and elective colorectal surgery. Br J Surg 77: 513–518

    Article  CAS  PubMed  Google Scholar 

  12. Juul P, Klaaborg KE, Kronborg O (1987) Single or multiple doses of metronidazole and Ampicillin in elective colorectal surgery: a randomized trial. Dis Colon Rectum 30: 526–528

    Article  CAS  PubMed  Google Scholar 

  13. Katkouda N, Hurwitz MB, Rivera RT, Chandra M, Waldrep DJ, Gugenheim J, Mouiel J (1998) Laparoscopic splenectomy: outcome and efficacy in 103 consecutive patients. Ann Surg 228: 568–578

    Article  Google Scholar 

  14. Keulemans Y, Eshuis J, De Haes H, De Wit LT, Gouma DJ (1998) Laparoscopic cholecystectomy: day-care versus clinical observation. Ann Surg 228: 734–740

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  15. Kockerling F, Schneider C, Reymond MA, Scheidbach H, Konradt J, Barlehner E, Bruch HP, Kuthe A, Troidl H, Hohenberger W (1998) Early results of a prospective multicenter study on 500 consecutive cases of laparoscopic colorectal surgery. Surg Endosc 12: 37–41 DOI: 10.1007/s004649900588

    Article  CAS  PubMed  Google Scholar 

  16. Lau WY, Chu KW, Poon GP, Ho KK (1988) Prophylactic antibiotics in elective colorectal surgery. Br J Surg 75: 782–785

    Article  CAS  PubMed  Google Scholar 

  17. Liavag I, Roland M (1983) Abdominoperineal excision of the rectum: a prospective study based on a standardized method. World J Surg 7: 241–246

    Article  CAS  PubMed  Google Scholar 

  18. Litwin DEW, Girotti MJ, Poulin EC, Mamazza J, Nagy AG (1992) Laparoscopic cholecystectomy: trans-Canada experience with 2001 cases. Can J Surg 35: 291–296

    CAS  PubMed  Google Scholar 

  19. Lumley JW, Fielding GA, Rhodes M, Nathanson LK, Siu S, Stitz RW (1996) Laparoscopic-assisted colorectal surgery: lessons learned from 240 consecutive patients. Dis Colon Rectum 39: 155–159

    Article  CAS  PubMed  Google Scholar 

  20. Lumley JW, Siu SK, Pillay SP, Stitz R, Kemp RJ, Faogali J, Nathanson LK (1992) Single dose ceftriaxone as prophylaxis for sepsis in colorectal surgery. Aust N Z J Surg 62: 292–296

    Article  CAS  PubMed  Google Scholar 

  21. McArdle CS, Morran CG, Pettit L, Gemmell CG, Sleight JD, Tillotson GS (1995) Value of oral antibiotic prophylaxis in colorectal surgery. Br J Surg 82: 1046–1048

    Article  CAS  PubMed  Google Scholar 

  22. McCulloch PG, Blamey SL, Finlay IG, Baird A, Sleigh D, Gardner E, McArdle CS (1986) A prospective comparison of gentamycin and metronidazole and moxalactam in the prevention of septic complications associated with elective operations of the colon and rectum. Surg Gynecol Obstet 162: 521–524

    CAS  PubMed  Google Scholar 

  23. Mendes da Costa P, Kaufman L (1992) Amikacin once daily plus metronidazole versus amikacin twice daily plus metronidazole in colorectal surgery. Hepatogastroenterology 39: 350–354

    CAS  PubMed  Google Scholar 

  24. Milsom JW, Smith DL, Corman ML, Howerton RA, Yellin AE, Luke DR (1998) Double-blind comparison of single-dose alatrofloxacin and cefotetan as prophylaxis of infection following elective colorectal surgery. Am J Surg 176: 46S-52S

    Article  CAS  PubMed  Google Scholar 

  25. Periti P, Mazzei T, Tonelli F (1989) Single-dose cefotetan vs. multiple-dose cefoxitin antimicrobial prophylaxis in colorectal surgery. Dis Colon Rectum 32: 121–127

    Article  CAS  PubMed  Google Scholar 

  26. Perkidis G, Hinder RA, Lund RJ, Raiser F, Katada N (1997) Laparoscopic Nissen fundoplication: where do we stand? Surg Laparosc Endosc 7: 17–21

    Article  Google Scholar 

  27. Poulin EC, Mamazza J, Breton G, Fortin CL, Wabha R, Ergina P (1992) Evaluation of pulmonary function in laparoscopic cholecystectomy. Surg Laparosc Endosc 4: 292–296

    Google Scholar 

  28. Rowe-Jones DC, Peel ALG, Kingston RD, Shaw JFL, Teasdale C, Cole DS (1990) Single-dose cefotaxime plus metronidazole versus three dose cefuroxime plus metronidazole as prophylaxis against wound infection in colorectal surgery: multicentre prospective randomized study. Br J Surg 300: 18–22

    CAS  Google Scholar 

  29. Rohwedder R, Bonadeo F, Benati M, Ojea Quintana G, Vaccaro C (1993) Single-dose oral ciprofloxacin plus parenteral metronidazole for perioperative antibiotic prophylaxis in colorectal surgery. Chemotherapy 39: 218–224

    Article  CAS  PubMed  Google Scholar 

  30. Song F, Glenny M (1998) Antimicrobial prophylaxis in colorectal surgery: a systematic review of randomized controlled trials. Br J Surg 85: 1232–1241

    Article  CAS  PubMed  Google Scholar 

  31. The Southern Surgeons Club A prospective analysis of 1518 laparoscopic cholecystectomies. N Engl J Med 324: 1073–1078

  32. Walker CBJ, Bruce DM, Heys SD, Gough DB, Binnie NR, Eremin O (1999) Minimal modulation of lymphocyte and natural killer cell subsets following minimal access surgery. Am J Surg 177: 48–54

    Article  CAS  PubMed  Google Scholar 

  33. Watson RG, Redmond HP, McCarthy J (1995) Exposure of the peritoneal cavity to air regulates early inflammatory responses to surgery in a murine model. Br J Surg 82: 1060–1065

    Article  CAS  PubMed  Google Scholar 

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Online publication: 18 October 2000

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Poulin, E.C., Schlachta, C.M., Seshadri, P.A. et al. Septic complications of elective laparoscopic colorectal resection. Surg Endosc 15, 203–208 (2001). https://doi.org/10.1007/s004640000234

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