Department of Oral and Maxillofacial Surgery, Southern TOHOKU General Hospital, Koriyama, Fukushima, Japan.
Department of Minimally Invasive Surgical and Medical Oncology, Fukushima Medical University, Fukushima, Fukushima, Japan.
PLoS One. 2020 Nov 9;15(11):e0242091. doi: 10.1371/journal.pone.0242091. eCollection 2020.
Perioperative oral management has been reported to be effective for preventing postoperative infectious complications. In addition, severe periodontal disease was identified as the significant risk factor for complications after gastrointestinal surgery. We investigated the bacteriological association between the periodontal pocket, stomach mucosa and drainage fluid to determine whether oral bacteria directly cause intra-abdominal infection after gastrectomy.
Patients who were scheduled to undergo surgery for gastric cancer were prospectively enrolled. We evaluated the similarity of bacterial strains in periodontal pocket, stomach mucosa and fluid from drainage tube. Gingival crevicular fluid and dental plaque were collected from the periodontal pocket and cultured to detect bacteria. Specimens from the resected stomach were collected and used for bacterial culturing. Drainage fluid from the abdominal cavity was also cultured.
All of 52 patients were enrolled. In the periodontal pocket, α-Streptococcus spp., Neisseria sp., and Prevotella sp. were mainly detected. Bacterial cultures in the stomach mucosa were positive in 26 cases. In 20 cases (76.9%), the detected strains were the same as those in the periodontal pocket. Six patients had the postoperative intra-abdominal infection after gastrectomy, and the same bacterial strains was detected in both of drainage fluid and periodontal pocket in two patients with severe periodontal disease.
We found the bacteriological association that same strain detected in periodontal pocket, stomach and in intra-abdominal drainage fluid after gastrectomy in patients with periodontal disease.
围手术期口腔管理已被报道可有效预防术后感染性并发症。此外，严重的牙周病被认为是胃肠道手术后并发症的重要危险因素。我们研究了牙周袋、胃黏膜和引流液之间的细菌学关联，以确定口腔细菌是否会直接导致胃癌手术后的腹腔内感染。
前瞻性纳入拟行胃癌手术的患者。我们评估了牙周袋、胃黏膜和引流管液中细菌菌株的相似性。从牙周袋采集龈沟液和牙菌斑进行细菌培养。采集切除胃的标本进行细菌培养。同时对腹腔引流液进行培养。
共纳入 52 例患者。在牙周袋中，主要检测到α-链球菌、奈瑟菌和普雷沃菌。26 例胃黏膜细菌培养阳性。在 20 例（76.9%）中，检测到的菌株与牙周袋中的相同。6 例胃癌患者术后发生腹腔内感染，2 例严重牙周病患者的引流液和牙周袋中均检测到相同的细菌菌株。
我们发现了牙周病患者在牙周袋、胃和胃癌术后腹腔引流液中存在相同细菌菌株的细菌学关联。
