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Rate of Organ Space Infection Is Reduced with the Use of an Air Leak Test During Major Hepatectomies

  • 2016 SSAT Plenary Presentation
  • Published:
Journal of Gastrointestinal Surgery

Abstract

Background

Organ/space surgical site infections (OSIs) constitute an important postoperative metric. We sought to assess the impact of a previously described air leak test (ALT) on the incidence of OSI following major hepatectomies.

Methods

A single-institution hepatobiliary database was queried for patients who underwent a major hepatectomy without biliary-enteric anastomosis between January 2009 and June 2015. Demographic, clinicopathologic, and intraoperative data—including application of ALT—were analyzed for associations with postoperative outcomes, including OSI, hospital length of stay (LOS), morbidity and mortality rates, and readmission rates.

Results

Three hundred eighteen patients were identified who met inclusion criteria, of whom 210 had an ALT. ALT and non-ALT patients did not differ in most disease and treatment characteristics, except for higher rates of trisegmentectomy among ALT patients (53 vs. 34 %, p = 0.002). ALT patients experienced lower rates of OSI and 90-day morbidity than non-ALT patients (5.2 vs. 13.0 %, p = 0.015 and 24.8 vs. 40.7 %, p = 0.003, respectively). In turn, OSI was the strongest independent predictor of longer LOS (OR = 4.89; 95 % CI, 2.80–6.97) and higher rates of 30- (OR = 32.0; 95 % CI, 10.9–93.8) and 45-day readmissions (OR = 29.4; 95 % CI, 10.2–84.6).

Conclusions

The use of an intraoperative ALT significantly reduces the rate of OSI following major hepatectomy and may contribute to lower post-discharge readmission rates.

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All authors have granted final approval of the version to be published and agree to be held accountable for all aspects of the work and its accuracy and integrity.

Author Contribution

Study concept and design: Tran Cao, Conrad, Aloia, Vauthey

Acquisition of data: Tran Cao, Phuoc, Ismael, Passot, Yamashita

Analysis and interpretation: Tran Cao, Vauthey

Drafting of manuscript: Tran Cao, Vauthey

Critical revisions: Tran Cao, Phuoc, Ismael, Denbo, Passot, Yamashita, Conrad, Aloia, Vauthey

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Authors and Affiliations

  1. Division of Surgical Oncology, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, 2002 Holcombe Blvd., OCL 112, Houston, TX, 77030, USA

    H. S. Tran Cao

  2. Department of Surgical Oncology, U.T. MD Anderson Cancer Center, Houston, TX, USA

    V. Phuoc, H. Ismael, J. W. Denbo, G. Passot, S. Yamashita, C. Conrad, T. A. Aloia & J. N. Vauthey

Authors
  1. H. S. Tran Cao
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  2. V. Phuoc
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  3. H. Ismael
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  4. J. W. Denbo
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  5. G. Passot
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  6. S. Yamashita
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  7. C. Conrad
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  8. T. A. Aloia
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  9. J. N. Vauthey
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Correspondence to H. S. Tran Cao.

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Tran Cao, H.S., Phuoc, V., Ismael, H. et al. Rate of Organ Space Infection Is Reduced with the Use of an Air Leak Test During Major Hepatectomies. J Gastrointest Surg 21, 85–93 (2017). https://doi.org/10.1007/s11605-016-3209-9

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  • DOI: https://doi.org/10.1007/s11605-016-3209-9

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