腹腔镜和机器人辅助的右侧结肠癌体外吻合手术中的肠道准备和手术部位感染：一项回顾性研究

IF 2.9 4区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Annals of Gastroenterological Surgery Pub Date : 2024-12-19 DOI:10.1002/ags3.12896

Naoya Ozawa, Tomohiro Yamaguchi, Takumi Kozu, Tatsuki Noguchi, Takashi Sakamoto, Shimpei Matsui, Toshiki Mukai, Takashi Akiyoshi, Yosuke Fukunaga

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引用次数: 0

摘要

目的以前的研究已经检查了肠道准备作为降低手术部位感染（SSI）率的措施。本回顾性研究旨在确定右半结肠癌体内吻合（IA）手术中SSI的危险因素。我们关注围手术期因素，包括肠准备方法，以阐明术前机械肠准备（MBP）和口服抗生素（OA）对SSI发生率的影响。方法纳入2019年和2023年接受选择性腹腔镜或机器人辅助结肠切除术的右侧结肠癌患者（n = 150）。使用单因素和多因素分析检查SSI的潜在危险因素。结果总发生率为11例（7.3%），其中切口部位SSI 8例（5.4%），器官/间隙SSI 3例（1.9%）。单因素分析显示OA （p < 0.001）和MBP （p = 0.002）显著降低SSI发生率。多因素分析确定OA为独立危险因素(风险比0.142；95%置信区间为0.025-0.827；p = 0.025)。与没有SSI的患者相比，SSI患者术后住院时间更长（中位9天对8天，p = 0.012）。术后第1天，OA组白细胞计数（9390 vs. 10 900/μL, p = 0.005）和c反应蛋白水平（3.81 vs. 7.83 mg/dL, p < 0.001）明显低于未OA组。结论腹腔镜或机器人辅助的右侧结肠癌IA手术术前给予OA可降低SSI的发生率。

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Bowel preparation and surgical site infections in laparoscopic and robot-assisted right-sided colon cancer surgery with intracorporeal anastomosis: A retrospective study

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Bowel preparation and surgical site infections in laparoscopic and robot-assisted right-sided colon cancer surgery with intracorporeal anastomosis: A retrospective study

Aim

Previous studies have examined bowel preparation as a measure to reduce surgical site infection (SSI) rates. This retrospective study aimed to identify the risk factors for SSI in right-sided colon cancer surgery using intracorporeal anastomosis (IA). We focused on perioperative factors, including the bowel preparation method, to clarify the impact of preoperative mechanical bowel preparation (MBP) and oral antibiotics (OA) on SSI incidence.

Methods

Patients (n = 150) with right-sided colon cancer who underwent elective laparoscopic or robot-assisted colectomy (2019 and 2023) were included. Potential risk factors for SSI were examined using univariate and multivariate analyses.

Results

The overall incidence of SSI was 11 (7.3%) cases, with eight (5.4%) cases classified as incision site SSI and three (1.9%) as organ/space SSI. Univariate analysis showed that OA (p < 0.001) and MBP (p = 0.002) significantly reduced the SSI rate. Multivariate analysis identified OA as an independent risk factor (hazard ratio, 0.142; 95% confidence interval, 0.025–0.827; p = 0.025). Patients with SSI had longer postoperative hospital stays compared to those without SSI (median 9 vs. 8 days, p = 0.012). On postoperative day 1, the group receiving OA had significantly lower white blood cell count (9390 vs. 10 900/μL, p = 0.005) and C-reactive protein levels (3.81 vs. 7.83 mg/dL, p < 0.001) compared to those in the group not receiving OA.