Jilin Provincial Key Laboratory of Surgical Translational Medicine, Division of Thyroid Surgery, China-Japan Union Hospital of Jilin University, Changchun, China.
Division of Breast and Endocrine Surgery, Department of Surgery, Minimally Invasive Surgery and Robotic Surgery Center, KUMC Thyroid Center Korea University, Anam Hospital.
Surg Laparosc Endosc Percutan Tech. 2024 Jun 1;34(3):248-258. doi: 10.1097/SLE.0000000000001067.
Our aim was to determine whether bacteria contamination occurred within the surgical field or on endoscopic equipment during surgery using the transoral endoscopic thyroidectomy vestibular approach (TOETVA).
Participants were recruited from patients planned for TOETVA between May 2017 and December 2019. Bacterial samples were taken before and at the conclusion of the TOETVA procedure. The preoperative and postoperative samples were taken from the endoscopic materials and inferior oral vestibulum using a sterile flocked swab.
The study resulted in 480 samples (80 TOETVAs). No vestibular, port site, or neck infections occurred in any of the patients. Three (3.7%) out of 80 patients developed postoperative fever. Our results show different microbial communities during TOETVA. The most prevalent species detected were S treptococcus species. Multivariate logistic regression analyses revealed that the degree of contamination depended on the sampling site (inferior vestibulum > equipment) ( P =0.03). In addition, the abundance of bacteria was affected by operative time ( P =0.013). There were no significant differences observed in isolation frequencies of bacteria in malignancy ( P =0.34).
TOETVA surgery is categorized as a "clean-contaminated" operation. A swab identified the common colonizers of oral microbiota on the endoscopic equipment and within the surgical field.
我们的目的是确定经口内镜甲状腺手术前庭入路（TOETVA）手术过程中，细菌污染是发生在手术部位还是内镜设备上。
本研究招募了 2017 年 5 月至 2019 年 12 月期间计划接受 TOETVA 的患者。在 TOETVA 手术前后采集细菌样本。术前和术后样本均使用无菌植绒拭子从内镜材料和口腔下前庭处采集。
本研究共纳入 480 例（80 例 TOETVA）患者。所有患者均未发生前庭、端口部位或颈部感染。80 例患者中有 3 例（3.7%）术后发热。我们的研究结果显示，TOETVA 期间存在不同的微生物群落。最常见的检测到的菌种为链球菌属。多变量逻辑回归分析显示，污染程度取决于采样部位（下前庭>设备）（P=0.03）。此外，细菌丰度受手术时间的影响（P=0.013）。在恶性肿瘤中，细菌分离频率未见显著差异（P=0.34）。
TOETVA 手术被归类为“清洁-污染”手术。拭子可识别出内镜设备和手术部位中口腔微生物群的常见定植菌。
