Department of Hospital Infection Management, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, China.
Department of Head and Neck Surgery, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, China.
J Hosp Infect. 2015 Nov;91(3):237-43. doi: 10.1016/j.jhin.2015.05.017. Epub 2015 Jun 27.
Various risk factors for surgical site infection (SSI) have been identified such as age, overweight, duration of surgery, blood loss, etc. Intraperitoneal chemotherapy during surgery is a common procedure in patients with gastric cancer, yet its impact on SSI has not been evaluated.
To evaluate whether intra-operative intraperitoneal chemotherapy is a key risk factor for organ/space SSI in patients with gastric cancer.
All patients with gastric cancer who underwent surgery at the Department of Gastrointestinal Surgery between January 2008 and December 2013 were studied. The organ/space SSI rates were compared between patients who received intra-operative intraperitoneal chemotherapy and patients who did not receive intra-operative intraperitoneal chemotherapy, and the risk factors for organ/space SSI were analysed by univariate and multi-variate regression analyses. The microbial causes of organ/space SSI were also identified.
Of the eligible 845 patients, 356 received intra-operative intraperitoneal chemotherapy, and the organ/space SSI rate was higher in these patients compared with patients who did not receive intra-operative intraperitoneal chemotherapy (9.01% vs 3.88%; P = 0.002). Univariate analysis confirmed the significance of this finding (odds ratio 2.443; P = 0.003). As a result, hospital stay was increased in patients who received intra-operative intraperitoneal chemotherapy {mean 20.91 days [95% confidence interval (CI) 19.76-22.06] vs 29.72 days (95% CI 25.46-33.99); P = 0.000}. The results also suggested that intra-operative intraperitoneal chemotherapy may be associated with more Gram-negative bacterial infections.
Intra-operative intraperitoneal chemotherapy is a significant risk factor for organ/space SSI in patients with gastric cancer.
已确定多种手术部位感染（SSI）的风险因素，如年龄、超重、手术时间、失血量等。术中腹腔内化疗是胃癌患者的常见治疗方法，但尚未评估其对 SSI 的影响。
评估术中腹腔内化疗是否是胃癌患者发生器官/腔隙 SSI 的关键危险因素。
研究了 2008 年 1 月至 2013 年 12 月在胃肠外科接受手术治疗的所有胃癌患者。比较了接受术中腹腔内化疗的患者和未接受术中腹腔内化疗的患者的器官/腔隙 SSI 发生率，并通过单变量和多变量回归分析了器官/腔隙 SSI 的危险因素。还确定了器官/腔隙 SSI 的微生物原因。
在 845 名符合条件的患者中，有 356 名患者接受了术中腹腔内化疗，与未接受术中腹腔内化疗的患者相比，这些患者的器官/腔隙 SSI 发生率更高（9.01%比 3.88%；P=0.002）。单变量分析证实了这一发现的意义（优势比 2.443；P=0.003）。因此，接受术中腹腔内化疗的患者住院时间延长[平均 20.91 天（95%置信区间（CI）19.76-22.06）比 29.72 天（95% CI 25.46-33.99）；P=0.000]。结果还表明，术中腹腔内化疗可能与更多革兰氏阴性菌感染有关。
术中腹腔内化疗是胃癌患者发生器官/腔隙 SSI 的显著危险因素。
