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Clinical impact of periodontal disease on postoperative complications in gastrointestinal cancer patients

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Abstract

Background

The effectiveness of perioperative oral management in gastrointestinal surgery remains unclear. To elucidate the clinical significance of oral care, we investigated the relationship between the oral environment and postoperative infectious complications (POICs) in patients undergoing gastrointestinal surgery.

Methods

This was a single-institute and historical cohort study of 341 patients. The participants were isolated from consecutive patients undergoing planned radical resection for gastrointestinal carcinoma from January 2016 to June 2017. Dentists assessed the oral environment for periodontal disease, hygiene status, dry mouth, fur on tongue, and tooth stumps. All patients received scaling and tooth brushing instructions. A stepwise logistic regression analysis was conducted to identify risk factors for POICs among the different oral statuses.

Results

The surgical procedures performed were gastrectomy in 123 (36.1%), colorectal resection in 185 (54.2%), and pancreatoduodenectomy or others in 38 (11.1%). POICs occurred in 48 patients (14.1%), including deep organ space infection in 20, surgical site infection in 11, anastomotic leakage in 5, urinary tract infection in 4, pneumonia in 2, and others in 6. After adjusting for confounding factors, periodontal disease was isolated as an independent risk factor for POICs (odds ratio 2.091, p = 0.037, 95% confidence interval 1.045–4.183). Other variables of oral environment such as hygiene status, dry mouth, fur on tongue, and tooth stumps did not have a significant impact on POICs.

Conclusions

Periodontal disease is a risk factor for infectious complications after gastrointestinal surgery.

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References

  1. Bergan EH, Tura BR, Lamas CC (2014) Impact of improvement in preoperative oral health on nosocomial pneumonia in a group of cardiac surgery patients: a single arm prospective intervention study. Intensive Care Med 40(1):23–31. https://doi.org/10.1007/s00134-013-3049-y

    Article  PubMed  Google Scholar 

  2. Spreadborough P, Lort S, Pasquali S et al (2016) A systematic review and meta-analysis of perioperative oral decontamination in patients undergoing major elective surgery. Perioperative medicine 5:6. https://doi.org/10.1186/s13741-016-0030-7

    Article  PubMed  PubMed Central  Google Scholar 

  3. Sato J, Goto J, Harahashi A et al (2011) Oral health care reduces the risk of postoperative surgical site infection in inpatients with oral squamous cell carcinoma. Support Care Cancer 19(3):409–416. https://doi.org/10.1007/s00520-010-0853-6

    Article  PubMed  Google Scholar 

  4. Bebko SP, Green DM, Awad SS (2015) Effect of a preoperative decontamination protocol on surgical site infections in patients undergoing elective orthopedic surgery with hardware implantation. JAMA Surg 150(5):390–395. https://doi.org/10.1001/jamasurg.2014.3480

    Article  PubMed  Google Scholar 

  5. Wilson W, Taubert KA, Gewitz M et al (2007) Prevention of infective endocarditis: guidelines from the American Heart Association: a guideline from the American Heart Association Rheumatic Fever, Endocarditis, and Kawasaki Disease Committee, Council on Cardiovascular Disease in the Young, and the Council on Clinical Cardiology, Council on Cardiovascular Surgery and Anesthesia, and the Quality of Care and Outcomes Research Interdisciplinary Working Group. Circulation 116(15):1736–1754. https://doi.org/10.1161/CIRCULATIONAHA.106.183095

    Article  PubMed  Google Scholar 

  6. Yoneyama T, Yoshida M, Matsui T et al (1999) Oral care and pneumonia. Oral Care Working Group. Lancet 354(9177):515

    Article  CAS  PubMed  Google Scholar 

  7. Wren SM, Martin M, Yoon JK et al (2010) Postoperative pneumonia-prevention program for the inpatient surgical ward. J Am Coll Surg 210(4):491–495. https://doi.org/10.1016/j.jamcollsurg.2010.01.009

    Article  PubMed  Google Scholar 

  8. Akutsu Y, Matsubara H, Shuto K et al (2010) Pre-operative dental brushing can reduce the risk of postoperative pneumonia in esophageal cancer patients. Surgery 147(4):497–502. https://doi.org/10.1016/j.surg.2009.10.048

    Article  PubMed  Google Scholar 

  9. Arimatsu K, Yamada H, Miyazawa H et al (2014) Oral pathobiont induces systemic inflammation and metabolic changes associated with alteration of gut microbiota. Sci Rep 4:4828. https://doi.org/10.1038/srep04828

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Lockhart PB, Brennan MT, Thornhill M et al (2009) Poor oral hygiene as a risk factor for infective endocarditis-related bacteremia. J Am Dent Assoc 140(10):1238–1244

    Article  PubMed  PubMed Central  Google Scholar 

  11. Nakatani S, Mitsutake K, Hozumi T et al (2003) Current characteristics of infective endocarditis in Japan: an analysis of 848 cases in 2000 and 2001. Circ J 67(11):901–905

    Article  PubMed  Google Scholar 

  12. Cotti E, Arrica M, Di Lenarda A et al (2017) The perioperative dental screening and management of patients undergoing cardiothoracic, vascular surgery and other cardiovascular invasive procedures: a systematic review. Eur J Prev Cardiol 24(4):409–425. https://doi.org/10.1177/2047487316682348

    Article  PubMed  Google Scholar 

  13. de Souza AF, Rocha AL, Castro WH (2016) Dental care before cardiac valve surgery: is it important to prevent infective endocarditis? Int J Cardiol Heart Vasc 12:57–62. https://doi.org/10.1016/j.ijcha.2016.07.001

    Article  PubMed  PubMed Central  Google Scholar 

  14. Stansby G, Byrne MT, Hamilton G (1994) Dental infection in vascular surgical patients. Br J Surg 81(8):1119–1120

    Article  CAS  PubMed  Google Scholar 

  15. Silvestre FJ, Gil-Raga I, Martinez-Herrera M et al (2017) Prior oral conditions in patients undergoing heart valve surgery. J Clin Exp Dent 9(11):e1287–e1291. https://doi.org/10.4317/jced.53902

    Article  PubMed  PubMed Central  Google Scholar 

  16. Salvi GE, Carollo-Bittel B, Lang NP (2008) Effects of diabetes mellitus on periodontal and peri-implant conditions: update on associations and risks. J Clin Periodontol 35(8 Suppl):398–409. https://doi.org/10.1111/j.1600-051X.2008.01282.x

    Article  PubMed  Google Scholar 

  17. Chavarry NG, Vettore MV, Sansone C et al (2009) The relationship between diabetes mellitus and destructive periodontal disease: a meta-analysis. Oral Health Prev Dent 7(2):107–127

    PubMed  Google Scholar 

  18. Humphrey LL, Fu R, Buckley DI et al (2008) Periodontal disease and coronary heart disease incidence: a systematic review and meta-analysis. J Gen Intern Med 23(12):2079–2086. https://doi.org/10.1007/s11606-008-0787-6

    Article  PubMed  PubMed Central  Google Scholar 

  19. Bahekar AA, Singh S, Saha S et al (2007) The prevalence and incidence of coronary heart disease is significantly increased in periodontitis: a meta-analysis. Am Heart J 154(5):830–837. https://doi.org/10.1016/j.ahj.2007.06.037

    Article  PubMed  Google Scholar 

  20. Yoneda M, Naka S, Nakano K et al (2012) Involvement of a periodontal pathogen, Porphyromonas gingivalis on the pathogenesis of non-alcoholic fatty liver disease. BMC Gastroenterol 12:16. https://doi.org/10.1186/1471-230X-12-16

    Article  PubMed  PubMed Central  Google Scholar 

  21. Pischon N, Pischon T, Kroger J et al (2008) Association among rheumatoid arthritis, oral hygiene, and periodontitis. J Periodontol 79(6):979–986. https://doi.org/10.1902/jop.2008.070501

    Article  CAS  PubMed  Google Scholar 

  22. Page RC (1998) The pathobiology of periodontal diseases may affect systemic diseases: inversion of a paradigm. Ann Periodontol 3(1):108–120. https://doi.org/10.1902/annals.1998.3.1.108

    Article  CAS  PubMed  Google Scholar 

  23. Periodontology TJSo (2016) Clinical practice guideline for the periodontal treatment. 2015 The Japanese Society of Periodontology

  24. Silness J, Loe H (1964) Periodontal disease in pregnancy. Ii. Correlation between oral hygiene and periodontal condition. Acta Odontol Scand 22:121–135

    Article  CAS  PubMed  Google Scholar 

  25. Miyazaki H, Sakao S, Katoh Y et al (1995) Correlation between volatile sulphur compounds and certain oral health measurements in the general population. J Periodontol 66(8):679–684. https://doi.org/10.1902/jop.1995.66.8.679

    Article  CAS  PubMed  Google Scholar 

  26. Dindo D, Demartines N, Clavien PA (2004) Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 240(2):205–213

    Article  PubMed  PubMed Central  Google Scholar 

  27. Oken MM, Creech RH, Tormey DC et al (1982) Toxicity and response criteria of the Eastern Cooperative Oncology Group. Am J Clin Oncol 5(6):649–655

    Article  CAS  PubMed  Google Scholar 

  28. Sobin LH, Gospodarowicz MK, Wittekind C (2011) TNM Classification of Malignant Tumours, 7th edn. Wiley, New York

    Google Scholar 

  29. Organization WH (2008) WHO Report on the global tobacco epidemic 2008: the MPOWER Package. https://www.who.int/tobacco/mpower/mpower_report_full_2008.pdf. Accessed Aug 2017

  30. Berrios-Torres SI, Umscheid CA, Bratzler DW et al (2017) Centers for disease control and prevention guideline for the prevention of surgical site infection. JAMA Surg 152(8):784–791. https://doi.org/10.1001/jamasurg.2017.0904

    Article  PubMed  Google Scholar 

  31. Tomas I, Diz P, Tobias A et al (2012) Periodontal health status and bacteraemia from daily oral activities: systematic review/meta-analysis. J Clin Periodontol 39(3):213–228. https://doi.org/10.1111/j.1600-051X.2011.01784.x

    Article  PubMed  Google Scholar 

  32. Lockhart PB, Brennan MT, Sasser HC et al (2008) Bacteremia associated with toothbrushing and dental extraction. Circulation 117(24):3118–3125. https://doi.org/10.1161/CIRCULATIONAHA.107.758524

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  33. Awano S, Ansai T, Takata Y et al (2008) Oral health and mortality risk from pneumonia in the elderly. J Dent Res 87(4):334–339. https://doi.org/10.1177/154405910808700418

    Article  CAS  PubMed  Google Scholar 

  34. Chiaki M, Kumiko K, Shouko K et al (2008) Preventive effects of postoperative pneumonia by thorough plaque control just before esophageal cancer operation. J Jpn Dent Hyg Assoc 2(2):43–47

    Google Scholar 

  35. Rickard AH, Gilbert P, High NJ et al (2003) Bacterial coaggregation: an integral process in the development of multi-species biofilms. Trends Microbiol 11(2):94–100

    Article  CAS  PubMed  Google Scholar 

  36. Ministry_of_Health_Labor_and_Welfare (2014). https://www.mhlw.go.jp/toukei/saikin/hw/kanja/14/dl/kanja-01.pdf. Accessed Aug 2017. Annal report of Patients' survey in Japan.

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Authors and Affiliations

  1. Department of Oral and Maxillofacial Surgery, Southern TOHOKU General Hospital, Koriyama, Japan

    Mao Nishikawa, Ryosuke Kimura, Ayaka Kobayashi, Yuji Yamaguchi, Susumu Iketani, Ichiro Seto & Kanichi Seto

  2. Department of Minimally Invasive Surgical and Medical Oncology, Fukushima Medical University, 1 Hikarigaoka, Fukushima, Fukushima, 960-1295, Japan

    Michitaka Honda, Hiroshi Kobayashi, Hidetaka Kawamura, Yujiro Nakayama, Yukitoshi Todate, Hisashi Yamaguchi & Koichi Hamada

  3. Department of Surgery, Southern TOHOKU General Hospital, Koriyama, Japan

    Michitaka Honda, Hiroshi Kobayashi, Hidetaka Kawamura, Yujiro Nakayama, Yukitoshi Todate & Yoshinao Takano

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  1. Mao Nishikawa
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  2. Michitaka Honda
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  3. Ryosuke Kimura
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  15. Kanichi Seto
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Correspondence to Michitaka Honda.

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Nishikawa, M., Honda, M., Kimura, R. et al. Clinical impact of periodontal disease on postoperative complications in gastrointestinal cancer patients. Int J Clin Oncol 24, 1558–1564 (2019). https://doi.org/10.1007/s10147-019-01513-y

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  • DOI: https://doi.org/10.1007/s10147-019-01513-y

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