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Effects of preoperative dental examination and oral hygiene instruction on surgical site infection after hepatectomy: a retrospective study

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Abstract

Purpose

This study retrospectively investigated relationships among risk factors and post-hepatectomy surgical site infection (SSI) and other complications in patients who underwent hepatectomy for hepatocellular carcinoma (HCC).

Methods

We included 334 patients who underwent hepatectomies for liver cancers between January 2011 and December 2015 in this study. We evaluated risk factors for SSI and other post-hepatectomy complication, including demographic factors, preoperative factors, and preoperative intervention including oral management, perioperative factors, and length of hospital stay, with univariate and multivariate analyses. The oral management intervention included self-care instructions, extraction of infected teeth, removal of dental plaques and calculus (scaling), professional mechanical teeth cleaning, removal of tongue coating, and cleaning of dentures. SSI was defined in accordance with the guideline issued by the Centers for Disease Control and Prevention; it included purulent discharge from any incision or organ space within 30 days postoperatively, with or without microbiological evidence. Complications of grade II or greater, according to the Clavien-Dindo classification, were regarded as postoperative complications.

Results

We found bacterial infection of ascites (Odds ratio (OR) = 13.72), lack of preoperative oral management intervention (OR = 10.17), and severe liver fibrosis (OR = 2.76) to be associated with SSI and severe liver fibrosis (OR = 2.28), hypoalbuminemia (OR = 2.02), blood transfusion (OR = 1.86), and longer operation time (OR = 1.80) to be associated with postoperative complications.

Conclusions

Preoperative oral management may reduce the risk of SSI in patients with HCC who undergo hepatectomy.

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Acknowledgments

We thank the Edanz Group (https://en-author-services.edanzgroup.com) for editing the draft of this manuscript.

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Authors and Affiliations

  1. Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan

    Takumi Hasegawa, Daisuke Takeda, Rika Amano, Izumi Saito, Yasumasa Kakei, Akira Kimoto & Masaya Akashi

  2. Department of Hepato-Biliary-Pancreatic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan

    Motofumi Tanaka & Takumi Fukumoto

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  1. Takumi Hasegawa
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  2. Daisuke Takeda
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Correspondence to Takumi Hasegawa.

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Hasegawa, T., Takeda, D., Tanaka, M. et al. Effects of preoperative dental examination and oral hygiene instruction on surgical site infection after hepatectomy: a retrospective study. Support Care Cancer 29, 653–659 (2021). https://doi.org/10.1007/s00520-020-05525-7

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  • DOI: https://doi.org/10.1007/s00520-020-05525-7

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