Luo Yang, Qiu Yi-Er, Mu Yi-Fei, Qin Shao-Lan, Qi Yang, Zhong Ming, Yu Min-Hao, Ma Li-Ying
Department of Gastrointestinal Surgery, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, P.R. China.
Medicine (Baltimore). 2017 Sep;96(37):e7752. doi: 10.1097/MD.0000000000007752.
Laparoscopic surgery is widespread and safe for the management of patients with colorectal cancer (CRC). Although the use of standard surgical techniques can prevent perioperative wound infections, surgical site infections (SSIs) remain an unresolved complication in laparoscopic-assisted colectomy. The present study investigated the ability of plastic wound protectors applied to the extraction incision during the externalized portion of the procedure to reduce the rate of infection in laparoscopic-assisted colectomy. We completed a retrospective review of the medical records of patients who underwent nonemergent laparoscopic-assisted between January 2015 and June 2016. Outcomes for patients with and without the use of a wound protector were compared. A total of 109 patients were included in this study. There was 1 patient in the wound protector group (n = 57) and 7 in the nonwound protector group (n = 52) who developed a wound infection at the colon extraction site (P = .02). Furthermore, the average postoperative hospital stay in the wound protector group was shorter compared to the nonwound protector group (7.47 ± 0.24 vs 8.73 ± 0.54 days, P = .03). In conclusion, this study indicates that the use of a plastic wound protector during laparoscope-assisted colectomy does reduce postoperative wound infection rates, and the wound protectors are beneficial for specimen extraction and digestive tract reconstruction.
腹腔镜手术在结直肠癌(CRC)患者的治疗中广泛应用且安全。尽管采用标准手术技术可预防围手术期伤口感染,但手术部位感染(SSIs)仍是腹腔镜辅助结肠切除术尚未解决的并发症。本研究调查了在手术外置部分将塑料伤口保护器应用于提取切口,以降低腹腔镜辅助结肠切除术感染率的能力。我们对2015年1月至2016年6月期间接受非急诊腹腔镜辅助手术患者的病历进行了回顾性分析。比较了使用和未使用伤口保护器患者的结局。本研究共纳入109例患者。伤口保护器组(n = 57)有1例患者,非伤口保护器组(n = 52)有7例患者在结肠提取部位发生伤口感染(P = 0.02)。此外,伤口保护器组的术后平均住院时间比非伤口保护器组短(7.47±0.24天 vs 8.73±0.54天,P = 0.03)。总之,本研究表明在腹腔镜辅助结肠切除术中使用塑料伤口保护器确实可降低术后伤口感染率,且伤口保护器有利于标本提取和消化道重建。