The preventive effects of perioperative oral care on surgical site infections after pancreatic cancer surgery: a retrospective study

Abstract Purpose: Pancreatic ductal adenocarcinoma (PDAC) is the most malignant cancer of the gastrointestinal tract, and is associated with high rates of postoperative complications, including surgical site infections (SSIs). Perioperative oral care is an effective measure for preventing postoperative pneumonia. However, the preventive effects of perioperative oral care on SSIs have not been reported. We investigated the preventive effects of perioperative oral care on SSIs after pancreatic cancer surgery.Methods: A total of 103 patients with PDAC who underwent radical resection at Hiroshima Prefectural Hospital (2011–2018) were enrolled in this retrospective study. Of the 103 patients, 75 received perioperative oral care by dentists and dental hygienists (oral care group), whereas 28 did not (control group). Univariate and multivariate analyses with propensity score as a covariate were used to investigate the incidence and risk factors of SSIs in the oral care and control groups. Results: The incidence of SSIs was significantly lower in the oral care group than in the control group (12.0% vs. 39.3%, P = 0.004). Logistic regression analysis revealed that a soft pancreas, the surgical procedure (pancreaticoduodenectomy), blood transfusion, diabetes mellitus, and the absence of oral care intervention were risk factors for SSIs. The odds ratio for oral care intervention was 0.164 (95% confidence interval: 0.047–0.571; P = 0.004). Conclusion: Perioperative oral care reduced the risk of developing SSIs after pancreatic cancer surgery. Our findings indicate that perioperative oral care is a safe and effective infection prevention strategy that should be implemented in future perioperative management.UMIN registration number: UMIN000042082; October 15, 2020, retrospectively registered.

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Cirurgia Paliativa em Pacientes com Tumor Periampular Irressecável: Estudo Retrospectivo de 5 Anos em um Hospital em São José dos Campos – SP/Surgical Palliation in Patients with Unresectable Periampullary Tumor: a Retrospective Study of 5 Years in a Hosp

REVISTA CIÊNCIAS EM SAÚDE ◽

10.21876/rcsfmit.v3i4.171 ◽

1970 ◽

Vol 3 (4) ◽

pp. 9-20

Author(s):

José Henrique Gomes Torres ◽

Rosyane Rena De Freitas

Keyword(s):

Pancreatic Cancer ◽

Retrospective Study ◽

Survival Rates ◽

Periampullary Tumor ◽

The Past ◽

Palliative Procedure ◽

Surgical Palliation ◽

Head Of The Pancreas ◽

Keywords Pancreatic Cancer ◽

Main Complication

Objetivo: Avaliar diferentes métodos paliativos quanto a sua resolução, complicações e sobrevida em pacientes com tumor periampular irressecável. Materiais e métodos: Estudo retrospectivo com análise dos prontuários de pacientes com tumor periampular irressecável e que foram submetidos a procedimento paliativo no Hospital Municipal Dr José de Carvalho Florence nos últimos cinco anos. Resultados: O principal tumor periampular foi o de cabeça de pâncreas, com incidência de 94%, acometendo pacientes com média de 66 anos, sem preferência por sexo. Os procedimentos mais realizados foram derivação biliar e colocação de endoprótese através de colangiopancreatografia endoscópica retrógrada, apresentando sobrevidas de 586 e 56 dias, respectivamente. Conclusão: A coledocojejunostomia foi o procedimento mais realizado e apresentou menor tempo de internação e maiores sobrevida e tempo de permanência anictérico. Pneumonia foi a complicação mais frequente. Palavras chave: Câncer pancreático, Colangiocarcinoma, Cuidados paliativos. Objective: To evaluate different palliative methods concerning its resolution, complications and survival in patients with unresectable periampular tumor. Materials and methods: Retrospective study analysing records of patients with unresectable periampullary tumor and who underwent palliative procedure in the Hospital Municipal Dr José de Carvalho Florence in the past five years. Results: The main periampullary tumor was the head of the pancreas, with an incidence of 94%, affecting patients with an average of 66 years old, regardless of gender. The most common procedures were bypass and biliary stent, with survival rates of 586 and 56 days, respectively. Conclusion: Coledocojejunostomy was the procedure which was the most often performed and showed a shorter hospital stay and longer survival time and time without jaundice. Pneumonia was the main complication. Keywords: Pancreatic cancer, Cholangiocarcinoma, Palliative care

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