The Department of Colon and Rectal Surgery, The Cleveland Clinic Foundation, Cleveland, Ohio, USA.
Colorectal Dis. 2011 Jul;13(7):811-5. doi: 10.1111/j.1463-1318.2010.02302.x. Epub 2010 Apr 29.
The morbidity of surgical site infections (SSIs) were compared in patients who underwent open (OS) vs laparoscopic (LS) colorectal surgery.
Data from 603 consecutive LS patients and 2246 consecutive OS patients were prospectively recorded. Morbidity of SSIs was assessed by the need for emergency department (ED) evaluation, subsequent hospital re-admission and re-operation. The cost of wound care was measured by the need for home healthcare, wound vacuum assisted closure (VAC) or independent patient wound care.
SSIs were identified in 5.8% (n = 25) of LS patients and 4.8% (n = 65) of OS patients. ED evaluation for the infection was needed in 24% of the LS group and 42% of the OS group. Hospital re-admission was needed in one LS patient and in 52% OS patients. No LS patient needed re-operation compared with 12% of OS patients. HHC ($162/dressing change) was required in 63% of the OS group compared with 8% of LS group. A home wound VAC system ($107/day) was utilized in 12% of the OS patients but in none of the LS patients. Dressing changes were managed independently by the patient in 92% of the LS compared with 37% of the OS patients.
Laparoscopic colorectal surgery patients experience less morbidity when they develop SSIs incurring less cost compared with open colorectal surgery patients.
比较接受开放式（OS）与腹腔镜（LS）结直肠手术的患者的手术部位感染（SSI）发病率。
前瞻性记录了 603 例连续 LS 患者和 2246 例连续 OS 患者的数据。通过急诊（ED）评估、随后的医院再入院和再手术的需要来评估 SSI 的发病率。通过家庭医疗保健、伤口真空辅助闭合（VAC）或独立患者伤口护理的需要来衡量伤口护理的成本。
LS 患者中 SSI 的发生率为 5.8%（n=25），OS 患者中为 4.8%（n=65）。感染的 LS 组中有 24%需要 ED 评估，OS 组中有 42%。1 例 LS 患者和 52%的 OS 患者需要再入院。与 OS 患者的 12%相比，没有 LS 患者需要再次手术。与 LS 组的 8%相比，OS 组中有 63%需要 HHC（每次换药 162 美元）。OS 患者中有 12%使用了家庭伤口 VAC 系统（每天 107 美元），但 LS 患者中没有。LS 患者中有 92%的患者可以独立管理伤口敷料更换，而 OS 患者中只有 37%。
与开放式结直肠手术患者相比，腹腔镜结直肠手术患者在发生 SSI 时发病率较低，成本较低。
