Ozawa Naoya, Yamaguchi Tomohiro, Kozu Takumi, Noguchi Tatsuki, Sakamoto Takashi, Matsui Shimpei, Mukai Toshiki, Akiyoshi Takashi, Fukunaga Yosuke
Department of Gastroenterological Surgery Cancer Institute Hospital of Japanese Foundation for Cancer Research Tokyo Japan.
Department of Colorectal Surgery Kansai Medical University Medical Center Osaka Japan.
Ann Gastroenterol Surg. 2024 Dec 19;9(4):711-718. doi: 10.1002/ags3.12896. eCollection 2025 Jul.
Previous studies have examined bowel preparation as a measure to reduce surgical site infection (SSI) rates. This retrospective study aimed to identify the risk factors for SSI in right-sided colon cancer surgery using intracorporeal anastomosis (IA). We focused on perioperative factors, including the bowel preparation method, to clarify the impact of preoperative mechanical bowel preparation (MBP) and oral antibiotics (OA) on SSI incidence.
Patients ( = 150) with right-sided colon cancer who underwent elective laparoscopic or robot-assisted colectomy (2019 and 2023) were included. Potential risk factors for SSI were examined using univariate and multivariate analyses.
The overall incidence of SSI was 11 (7.3%) cases, with eight (5.4%) cases classified as incision site SSI and three (1.9%) as organ/space SSI. Univariate analysis showed that OA ( < 0.001) and MBP ( = 0.002) significantly reduced the SSI rate. Multivariate analysis identified OA as an independent risk factor (hazard ratio, 0.142; 95% confidence interval, 0.025-0.827; = 0.025). Patients with SSI had longer postoperative hospital stays compared to those without SSI (median 9 vs. 8 days, = 0.012). On postoperative day 1, the group receiving OA had significantly lower white blood cell count (9390 vs. 10 900/μL, = 0.005) and C-reactive protein levels (3.81 vs. 7.83 mg/dL, < 0.001) compared to those in the group not receiving OA.
Preoperative administration of OA in laparoscopic or robot-assisted right-sided colon cancer surgery with IA may help decrease the incidence of SSI.
以往研究将肠道准备作为降低手术部位感染（SSI）率的一项措施。本回顾性研究旨在确定使用体内吻合术（IA）的右侧结肠癌手术中SSI的危险因素。我们重点关注围手术期因素，包括肠道准备方法，以阐明术前机械性肠道准备（MBP）和口服抗生素（OA）对SSI发生率的影响。
纳入2019年至2023年接受择期腹腔镜或机器人辅助结肠切除术的右侧结肠癌患者（n = 150）。使用单因素和多因素分析检查SSI的潜在危险因素。
SSI的总体发生率为11例（7.3%），其中8例（5.4%）为切口部位SSI，3例（1.9%）为器官/腔隙SSI。单因素分析显示，OA（P < 0.001）和MBP（P = 0.002）显著降低了SSI率。多因素分析确定OA为独立危险因素（风险比，0.142；95%置信区间，0.025 - 0.827；P = 0.025）。与未发生SSI的患者相比，发生SSI的患者术后住院时间更长（中位数9天对8天，P = 0.012）。术后第1天，接受OA的组白细胞计数（9390对10900/μL，P = 0.005）和C反应蛋白水平（3.81对7.83mg/dL，P < 0.001）显著低于未接受OA的组。
在采用IA的腹腔镜或机器人辅助右侧结肠癌手术中，术前给予OA可能有助于降低SSI的发生率。
