Yamamoto Masashi, Tanaka Keitaro, Asakuma Mitsuhiro, Kondo Keisaku, Isii Masatsugu, Hamamoto Hiroki, Okuda Junji, Uchiyama Kazuhisa
Department of General and Gastroenterological Surgery, Osaka Medical College Hospital, Takatsuki, Osaka, Japan.
Am Surg. 2015 Dec;81(12):1232-6.
Laparoscopic surgery is widespread and is safe and effective for the management of patients with colorectal cancer. However, surgical site infection (SSI) remains an unresolved complication. The present study investigated the comparative effect of supraumbilical incision versus transumbilical incision (TU) on the incidence of SSI in patients undergoing laparoscopic surgery for colon cancer. Medical records from patients with colorectal cancer who underwent laparoscopic sigmoid and rectosigmoid colon surgeries with either supraumbilical incision (n = 150) or TU (n = 150) were retrospectively reviewed. There was no difference in demographics, comorbidities, or operative variables between the two groups. The transumbilical group and the supraumbilical group were comparable with regards to overall SSI (6.0% vs 4.0%; P = 0.4062), superficial SSI (6.0% vs 3.3%; P = 0.2704), and deep SSI (0% vs 0.7%; P = 0.2385). SSI developed after laparoscopic sigmoid and rectosigmoid colon cancer surgery in 15 (5.0%) of the 300 patients. Of these superficial SSI, all wounds were in the left lower quadrant incision, and the transumbilical port sites did not become infected. Univariate analysis failed to identify any risk factors for SSI. Avoidance of the umbilicus offers no benefit with regard to SSI compared with TU.
腹腔镜手术应用广泛，对于结直肠癌患者的治疗安全有效。然而，手术部位感染（SSI）仍是一个尚未解决的并发症。本研究调查了脐上切口与经脐切口（TU）对接受腹腔镜结肠癌手术患者SSI发生率的比较影响。对接受腹腔镜乙状结肠和直肠乙状结肠手术且采用脐上切口（n = 150）或TU（n = 150）的结直肠癌患者的病历进行了回顾性分析。两组在人口统计学、合并症或手术变量方面无差异。经脐组和脐上组在总体SSI（6.0%对4.0%；P = 0.4062）、浅表SSI（6.0%对3.3%；P = 0.2704）和深部SSI（0%对0.7%；P = 0.2385）方面具有可比性。300例患者中有15例（5.0%）在腹腔镜乙状结肠和直肠乙状结肠癌手术后发生了SSI。在这些浅表SSI中，所有伤口均位于左下腹切口，经脐端口部位未发生感染。单因素分析未能确定SSI的任何危险因素。与TU相比，避开脐部在SSI方面并无益处。
