Capozzi Vito Andrea, De Finis Alessandra, Scarpelli Elisa, Gallinelli Asya, Monfardini Luciano, Cianci Stefano, Gulino Ferdinando Antonio, Rotondella Isabella, Celora Gabriella Maria, Martignon Giulia, Ghi Tullio, Berretta Roberto
Department of Medicine and Surgery, University Hospital of Parma, 43125 Parma, Italy.
Unit of Gynecology and Obstetric, Department of Human Pathology of Adult and Childhood "G. Barresi", University of Messina, 98125 Messina, Italy.
J Pers Med. 2024 Jan 29;14(2):147. doi: 10.3390/jpm14020147.
Minimally Invasive Surgery (MIS) represents a safe and feasible option for the surgical treatment of gynecologic malignancies, offering benefits, including reduced blood loss, lower complications, and faster recovery, without compromising oncological outcomes in selected patients. MIS is widely accepted in early-stage gynecologic malignancies, including endometrial cancer, cervical tumors measuring 2 cm or less, and early-stage ovarian cancer, considering the risk of surgical spillage. Despite its advantages, MIS does not rule out the possibility of adverse events such as postoperative infections. This retrospective study on 260 patients undergoing laparoscopic surgery at Parma University Hospital for gynecologic malignancies explores the incidence and risk factors of postoperative infectious complications. The Clavien-Dindo classification was used to rank postoperative surgical complications occurring 30 days after surgery and Enhanced Recovery After Surgery (ERAS) recommendations put into practice. In our population, 15 (5.8%) patients developed infectious complications, predominantly urinary tract infections (9, 3.5%). Longer surgical procedures were independently associated with higher postoperative infection risk ( = 0.045). Furthermore, C1 radical hysterectomy correlated significantly with infectious complications ( = 0.001, OR 3.977, 95% CI 1.370-11.544). In conclusion, compared to prior research, our study reported a lower rate of infectious complications occurrence and highlights the importance of adopting infection prevention measures.
微创手术(MIS)是妇科恶性肿瘤手术治疗的一种安全可行的选择,具有减少失血、降低并发症发生率和加快恢复等优点,且在特定患者中不影响肿瘤治疗效果。考虑到手术播散的风险,MIS在早期妇科恶性肿瘤中广泛应用,包括子宫内膜癌、直径2厘米及以下的宫颈肿瘤和早期卵巢癌。尽管MIS有诸多优点,但并不能排除术后感染等不良事件的发生。这项对帕尔马大学医院260例接受腹腔镜手术治疗妇科恶性肿瘤患者的回顾性研究,探讨了术后感染并发症的发生率及危险因素。采用Clavien-Dindo分类法对术后30天内发生的手术并发症进行分级,并实施了术后加速康复(ERAS)建议。在我们的研究人群中,15例(5.8%)患者发生了感染并发症,主要为尿路感染(9例,3.5%)。手术时间较长与术后感染风险较高独立相关(P = 0.045)。此外,C1根治性子宫切除术与感染并发症显著相关(P = 0.001,OR 3.977,95%CI 1.370 - 11.544)。总之,与先前的研究相比,我们的研究报告的感染并发症发生率较低,并强调了采取感染预防措施的重要性。