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腹腔镜结肠手术操作的改进与手术部位感染风险降低之间的关联。

The association between the increased performance of laparoscopic colon surgery and a reduced risk of surgical site infection.

作者信息

Kagawa Yoshinori, Yamada Daisaku, Yamasaki Makoto, Miyamoto Atsushi, Mizushima Tsunekazu, Yamabe Kazuo, Imazato Mitsunobu, Fukunaga Hiroki, Kobayashi Shogo, Shimizu Junzo, Umeshita Koji, Ito Toshinori, Doki Yuichiro, Mori Masaki

机构信息

Department of Surgery, Kansai Rosai Hospital, 3-1-69 Inabaso Amagasaki, Hyogo, 660-8511, Japan.

Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan.

出版信息

Surg Today. 2019 Jun;49(6):474-481. doi: 10.1007/s00595-019-1760-1. Epub 2019 Jan 25.

Abstract

PURPOSE

Surgical site infection (SSI) is the most frequently occurring nosocomial infection. Remarkable surgical progress has recently been made in laparoscopic surgery. Therefore, our objective was to investigate the association between increased rates of laparoscopic colon surgery and SSI.

METHODS

We retrospectively investigated SSI surveillance data from July 2003 to December 2015. Two university hospitals and 25 university-affiliated hospitals participated in prospective SSI surveillance. Univariate and multivariate analyses were performed to detect significant associations.

RESULTS

We investigated 9655 colon surgeries. The year in which surgery was performed was significantly associated with the SSI rate (p = 0.0381). The rate of laparoscopic surgery gradually increased during the study period, and by 2012 it was routinely used for > 50% of colon surgeries. Laparoscopic surgery became a significant factor associated with reduced SSI rates compared with conventional open surgery once the performance rate of laparoscopic surgery reached > 50%.

CONCLUSIONS

Increasing rates of laparoscopic colon surgery tended to be associated with a reduction in the SSI risk after surgical treatment of colonic disease. The results of this study might encourage surgeons to view laparoscopic surgical techniques as an evidence-based approach for reducing the risk of SSI.

摘要

目的

手术部位感染(SSI)是最常见的医院感染。近年来腹腔镜手术取得了显著的进展。因此,我们的目的是研究腹腔镜结肠手术比例增加与手术部位感染之间的关联。

方法

我们回顾性调查了2003年7月至2015年12月期间手术部位感染的监测数据。两家大学医院和25家大学附属医院参与了前瞻性手术部位感染监测。进行单因素和多因素分析以检测显著关联。

结果

我们调查了9655例结肠手术。手术年份与手术部位感染率显著相关(p = 0.0381)。在研究期间,腹腔镜手术的比例逐渐增加,到2012年,超过50%的结肠手术常规使用腹腔镜手术。一旦腹腔镜手术的实施率超过50%,与传统开放手术相比,腹腔镜手术成为手术部位感染率降低的一个显著相关因素。

结论

腹腔镜结肠手术比例的增加往往与结肠疾病手术治疗后手术部位感染风险的降低相关。本研究结果可能会鼓励外科医生将腹腔镜手术技术视为降低手术部位感染风险的一种循证方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b5e5/6526142/babd227ef0e3/595_2019_1760_Fig1_HTML.jpg

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