Özmen Tolga, Javadov Mirkhalig, Yeğen Cumhur S
Department of General Surgery, Marmara University School of Medicine, İstanbul, Turkey.
Ulus Cerrahi Derg. 2015 Sep 1;32(3):178-84. doi: 10.5152/UCD.2015.3135. eCollection 2016.
Surgical site infection (SSI) is a common complication after surgery and is an indicator of quality of care. Risk factors for SSI are studied thoroughly for most types of gastrointestinal surgeries and especially colorectal surgeries, but accumulated data is still lacking for gastric surgeries. We studied the parameters affecting SSI rate after gastric cancer surgery.
Consecutive patients, who underwent elective gastric cancer surgery between June and December 2013, were included. Descriptive parameters, laboratory values and past medical histories were recorded prospectively. All patients were followed for 1 month. Recorded parameters were compared between the SSI (+) and SSI (-) groups.
Fifty-two patients (mean age: 58.87±9.25 [31-80]; 67% male) were included. SSI incidence was 19%. ASA score ≥3 (p<0.001), postoperative weight gain (p<0.001), smoking (p=0.014) and body mass index (BMI) ≥30 (p=0.025) were related with a higher SSI incidence. Also patients in the SSI (+) group had a higher preoperative serum C-reactive protein level (p=0.014).
We assume that decreasing BMI to <30, stopping smoking at least 3 weeks before the operation, and preventing postoperative weight gain by avoiding excessive intravenous hydration will all help decrease SSI rate after gastric surgery.
手术部位感染（SSI）是手术后常见的并发症，也是医疗质量的一个指标。对于大多数类型的胃肠手术，尤其是结直肠手术，SSI的危险因素已得到充分研究，但胃癌手术的累积数据仍然缺乏。我们研究了影响胃癌手术后SSI发生率的参数。
纳入2013年6月至12月期间接受择期胃癌手术的连续患者。前瞻性记录描述性参数、实验室值和既往病史。所有患者随访1个月。比较SSI（+）组和SSI（-）组记录的参数。
纳入52例患者（平均年龄：58.87±9.25[31 - 80岁]；67%为男性）。SSI发生率为19%。美国麻醉医师协会（ASA）评分≥3（p<0.001）、术后体重增加（p<0.001）、吸烟（p = 0.014）和体重指数（BMI）≥30（p = 0.025）与较高的SSI发生率相关。此外，SSI（+）组患者术前血清C反应蛋白水平较高（p = 0.014）。
我们认为，将BMI降至<30、术前至少3周戒烟以及通过避免过度静脉补液防止术后体重增加，均有助于降低胃癌手术后的SSI发生率。
