Yamamoto Seiichiro, Fujita Shin, Ishiguro Seiji, Akasu Takayuki, Moriya Yoshihiro
Division of Colorectal Surgery, National Cancer Center Hospital, Tokyo, Japan.
Surg Today. 2008;38(7):618-22. doi: 10.1007/s00595-007-3684-4. Epub 2008 Jul 9.
The aim of this study was to investigate whether the wound infection (WI) rate in laparoscopic surgery (LS) for colorectal cancer is lower than that in open surgery (OS), and to evaluate the influence of perioperative intravenous antibiotic prophylaxis on the development of WI in LS.
We performed a meta-analysis study comparing the WI rate in patients who underwent either OS or LS in randomized controlled trials (RCTs), with a relatively large number of registered patients. Moreover, a subgroup analysis of recently reported RCTs from Japan was performed, and 290 consecutive patients who underwent LS for colorectal cancer at our institution were evaluated for the influence of perioperative intravenous antibiotic prophylaxis on the development of WI.
The WI rate of the LS group was significantly lower than that of the OS group in a meta-analysis; however, no positive effect of the intra-and postoperative antibiotic prophylaxis on the development of WI was demonstrated.
Laparoscopic surgery for colorectal cancer is considered a surgical technique that has a lower incidence of WI in comparison to OS. Well-designed prospective, randomized controlled trials should therefore be conducted to evaluate whether intraoperative repeated dosing or postoperative repeated dosing is effective in reducing WI in LS.
本研究旨在调查结直肠癌腹腔镜手术（LS）的伤口感染（WI）率是否低于开放手术（OS），并评估围手术期静脉使用抗生素预防对LS中WI发生的影响。
我们进行了一项荟萃分析研究，比较了随机对照试验（RCT）中接受OS或LS的患者的WI率，这些试验登记的患者数量相对较多。此外，对日本最近报道的RCT进行了亚组分析，并对我院290例连续接受结直肠癌LS的患者进行了评估，以探讨围手术期静脉使用抗生素预防对WI发生的影响。
荟萃分析显示，LS组的WI率显著低于OS组；然而，术前和术后使用抗生素预防对WI的发生没有显示出积极作用。
与OS相比，结直肠癌腹腔镜手术被认为是一种WI发生率较低的手术技术。因此，应进行精心设计的前瞻性随机对照试验，以评估术中重复给药或术后重复给药是否能有效降低LS中的WI。
