Does Transumbilical Incision Influence Surgical Site Infection Rates of the Laparoscopic Sigmoidectomy and Anterior Resection?

2015 ◽  
Vol 81 (12) ◽  
pp. 1232-1236 ◽  
Author(s):  
Masashi Yamamoto ◽  
Keitaro Tanaka ◽  
Mitsuhiro Asakuma ◽  
Keisaku Kondo ◽  
Masatsugu Isii ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Colon Cancer ◽  
Laparoscopic Surgery ◽  
Surgical Site Infection ◽  
Univariate Analysis ◽  
Site Infection ◽  
Infection Rates ◽  
Rectosigmoid Colon ◽  
Lower Quadrant ◽  
Colon Cancer Surgery

Laparoscopic surgery is widespread and is safe and effective for the management of patients with colorectal cancer. However, surgical site infection (SSI) remains an unresolved complication. The present study investigated the comparative effect of supraumbilical incision versus transumbilical incision (TU) on the incidence of SSI in patients undergoing laparoscopic surgery for colon cancer. Medical records from patients with colorectal cancer who underwent laparoscopic sigmoid and rectosigmoid colon surgeries with either supraumbilical incision (n = 150) or TU (n = 150) were retrospectively reviewed. There was no difference in demographics, comorbidities, or operative variables between the two groups. The transumbilical group and the supraumbilical group were comparable with regards to overall SSI (6.0% vs 4.0%; P = 0.4062), superficial SSI (6.0% vs 3.3%; P = 0.2704), and deep SSI (0% vs 0.7%; P = 0.2385). SSI developed after laparoscopic sigmoid and rectosigmoid colon cancer surgery in 15 (5.0%) of the 300 patients. Of these superficial SSI, all wounds were in the left lower quadrant incision, and the transumbilical port sites did not become infected. Univariate analysis failed to identify any risk factors for SSI. Avoidance of the umbilicus offers no benefit with regard to SSI compared with TU.

scholarly journals The safety of preoperative amino acid (Elental®) loading in colon cancer surgery: Prospective cohort study.

2017 ◽  
Author(s):  
Jun Watanabe ◽  
Mitsuyoshi Ota ◽  
Yusuke Suwa ◽  
Shinsuke Suzuki ◽  
Hirokazu Suwa ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Colon Cancer ◽  
Amino Acid ◽  
Surgical Site Infection ◽  
Bowel Movement ◽  
Cancer Surgery ◽  
Site Infection ◽  
Incisional Surgical Site Infection ◽  
Colon Cancer Surgery ◽  
Induction Of Anaesthesia

Abstract Objective: The aim of this prospective study was to evaluate the safety of preoperative amino acid plus CHO drink (Elental®) loading in colon cancer surgery. Summary of Background Data: Prolonged preoperative fasting increases insulin resistance and current evidence recommends carbohydrate drinks 2 hours before surgery. Methods: We prospectively enrolled consecutive patients with a preoperative diagnosis of colon cancer who underwent surgery. The patients received 600 ml of Elental® the night before surgery and 300 ml of Elental® 3 h prior to induction of anaesthesia. Primary endpoint was the safety of preoperative amino acid (Elental®) loading in colon cancer surgery. Safety measurement was anastomotic leakage and aspiration pneumonia. Secondary endpoints were incidence rate of incisional surgical site infection, recovery of bowel movement, length of hospital stay, postoperative nutritional status and insulin resistance. Results: A total of 80 consecutive patients were enrolled in this study from February 2013 to January 2014. The incidence of anastomotic leakage was 3 cases (3.8%) and there were no aspiration pneumonia. The incidence of incisional surgical site infection was 2 cases (2.5%). The median time of first flatus, defecation after surgery and postoperative hospital stay was 1 day, 2 days and 6 days. The insulin resistance recovered to a preoperative level after 3 days after surgery. Conclusion: The preoperative amino acid plus CHO drink (Elental®) loading 3h prior to induction of anaesthesia in colon cancer surgery is safe and incisional surgical site infection rate and recovery of bowel movement and insulin resistance are feasible.

scholarly journals Neutrophil priming as a risk factor for surgical site infection in patients with colon cancer treated by laparoscopic surgery

BMC Surgery ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Yuji Toiyama ◽  
Yoshinaga Okugawa ◽  
Tadanobu Shimura ◽  
Shozo Ide ◽  
Hiromi Yasuda ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Laparoscopic Surgery ◽  
Surgical Site Infection ◽  
Anastomotic Leakage ◽  
Cancer Patients ◽  
Tumor Markers ◽  
Laboratory Data ◽  
Site Infection ◽  
Clinicopathological Factors ◽  
Curative Surgery

Abstract Background The purpose of this study is to identify perioperative marker predicting postoperative surgical site infection (SSI) including with anastomotic leakage (AL) in curative colon cancer patients, laparoscopically. Methods In total, 135 colon cancer patients (stage I–III) undergoing curative laparoscopic surgery between January 2004 and December 2013 were enrolled in this study. We collected data on clinicopathological factors, laboratory data on pre and postoperative day 3 (POD3) and tumor markers levels to assess the relation to surgical site infection (SSI) including with anastomotic leakage (AL). Results SSI and AL occurred in 16 cases (5.6%) and 4 cases (3%), respectively. SSI and AL were not association with clinicopathological factors. Within laboratory data and tumor markers preoperatively, high neutrophil counts were significantly associated with SSI (P < 0.05) and AL (P < 0.01), respectively. Area under curves (AUC) of SSI and AL were 0.656 and 0.854, respectively. In addition, high neutrophil counts on POD3 also were significantly associated with SSI (P < 0.01) and AL (P < 0.01), respectively. Area under curves (AUC) of SSI and AL were 0.747 and 0.832, respectively. Conclusion Neutrophil count on pre and POD3 are potentially valuable indicators of SSI including with AL in colon cancer patients undergoing curative surgery laparoscopically.

scholarly journals Does Intracorporeal Anastomosis Decrease the Rate of Surgical Site Infection in Laparoscopic Colon Cancer Surgery?

2021 ◽  
Vol 105 (1-3) ◽  
pp. 643-648
Author(s):  
Yeon Wook Ju ◽  
Woong Bae Ji ◽  
Jung Sik Kim ◽  
Kwang Dae Hong ◽  
Jun Won Um
Keyword(s):  
Colon Cancer ◽  
Surgical Site Infection ◽  
Radical Surgery ◽  
Abdominal Cavity ◽  
Intracorporeal Anastomosis ◽  
Cancer Surgery ◽  
Site Infection ◽  
Extraction Site ◽  
Significant Difference ◽  
Colon Cancer Surgery

Objective This study aimed to compare the surgical site infection (SSI) rates between intracorporeal anastomosis (ICA) and extracorporeal anastomosis (ECA). Summary of background data Laparoscopic surgery is recommended for colonic malignancies because of its superior clinical outcomes and comparable oncologic results. Laparoscopic colectomy with ICA has the advantages of incision length and free extraction site choice. However, ICA may be associated with a risk of SSI due to enterotomy inside the abdominal cavity. Methods We retrospectively analyzed patients with colon cancer who underwent radical surgery at Korea University Ansan Hospital between January 2017 and June 2020. We compared the SSI rates and other clinical variables between the ICA and ECA groups. Results Of the 502 patients who underwent radical surgery for colorectal cancer during the study period, 234 were eligible for inclusion. ECA and ICA were performed in 62.4% and 37.6% of patients, respectively. There were no statistically significant intergroup differences in clinicopathologic variables. The overall SSI rate did not differ between the groups (P = 0.801), but organ/space SSIs were more common in the ICA group than in the ECA group (P = 0.048). Conclusions There was no significant difference in overall SSI or anastomotic leakage (AL) rates between the ICA and ECA groups, but the organ/space SSI rate was higher in the ICA group when AL cases were excluded. Further high-quality studies are needed to assess the risk of organ/space SSIs in the ICA after colon cancer surgery.

Risk Factors for Surgical Site Infection after Laparoscopic Surgery for Colon Cancer

2016 ◽  
Vol 17 (4) ◽  
pp. 454-458 ◽  
Author(s):  
Takatoshi Nakamura ◽  
Takeo Sato ◽  
Yoko Takayama ◽  
Masanori Naito ◽  
Takahiro Yamanashi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Colon Cancer ◽  
Laparoscopic Surgery ◽  
Surgical Site Infection ◽  
Site Infection

58 Use of Abdominal Wall or Sucutaneous Drain to Reduce the Risk of Surgical Site Infections

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
H Mistry ◽  
B Woolner ◽  
A John
Keyword(s):  
Surgical Site Infection ◽  
Open Cholecystectomy ◽  
Surgical Site Infections ◽  
Standard Operating Procedure ◽  
Site Infection ◽  
Infection Rates ◽  
Local Evidence ◽  
Audit Data ◽  
The Impact ◽  
To Receive

Abstract Introduction Open abdominal surgery confers potentially greater risk of surgical site infections, and local evidence suggests use of drains can reduce this. Our objectives were: Assessing local rates and risk factors of infections and if use of drains can reduce the rates of infections. Method Retrospectively looking from 01/01/2018 to 31/12/2018, at patients following laparotomy or open cholecystectomy. Data collection on demographics, smoking/alcohol status, heart, respiratory or renal disease or diabetes, steroid use and CEPOD status, as well as use of drain and the outcome of infection using inpatient and online patient records. Results 84 patients included, 25 had drains inserted. There were 13 documented cases of surgical site infection, all of whom had no drain post-op. Other parameters shown to be most prevalent in the patients with a surgical site infection include being current/ex-smoker (8/13), having heart disease (9/13), and elective procedures. Conclusions Aiming to reduce the risk of surgical site infections can improve morbidity and potentially mortality outcomes. Our audit data showed that there appears to be a benefit of inserting intra-abdominal or subcutaneous drains. We will create a standard operating procedure of all patient to receive drains post-op and then re-audit to assess the impact this has on infection rates.

scholarly journals Colorectal Cancer Surgery Quality in Manitoba: A Population-Based Descriptive Analysis

2021 ◽  
Vol 28 (3) ◽  
pp. 2239-2247
Author(s):  
Iresha Ratnayake ◽  
Jason Park ◽  
Natalie Biswanger ◽  
Allison Feely ◽  
Grace Musto ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Colon Cancer ◽  
Laparoscopic Surgery ◽  
Descriptive Analysis ◽  
Population Based ◽  
Cancer Surgery ◽  
Formal Structure ◽  
Colorectal Cancer Surgery ◽  
Surgical Quality ◽  
Clinical Variation

Unwarranted clinical variation in healthcare impacts access, productivity, performance, and outcomes. A strategy proposed for reducing unwarranted clinical variation is to ensure that population-based data describing the current state of health care services are available to clinicians and healthcare decision-makers. The objective of this study was to measure variation in colorectal cancer surgical treatment patterns and surgical quality in Manitoba and identify areas for improvement. This descriptive study included individuals aged 20 years or older who were diagnosed with invasive cancer (adenocarcinoma) of the colon or rectum between 1 January 2010 and 31 December 2014. Laparoscopic surgery was higher in colon cancer (24.1%) compared to rectal cancer (13.6%). For colon cancer, the percentage of laparoscopic surgery ranged from 12.9% to 29.2%, with significant differences by regional health authority (RHA) of surgery. In 86.1% of colon cancers, ≥12 lymph nodes were removed. In Manitoba, the negative circumferential resection margin for rectal cancers was 96.9%, and ranged from 96.0% to 100.0% between RHAs. The median time between first colonoscopy and resection was 40 days for individuals with colon cancer. This study showed that high-quality colorectal cancer surgery is being conducted in Manitoba along with some variation and gaps in quality. As a result of this work, a formal structure for ongoing measuring and reporting surgical quality has been established in Manitoba. Quality improvement initiatives have been implemented based on these findings and periodic assessments of colorectal cancer surgery quality will continue.

scholarly journals Surgical Site Infection and Validity of Staged Surgical Procedure in Emergent/Urgent Surgery for Ulcerative Colitis

2013 ◽  
Vol 98 (1) ◽  
pp. 24-32 ◽  
Author(s):  
Motoi Uchino ◽  
Hiroki Ikeuchi ◽  
Hiroki Matsuoka ◽  
Yoshiko Takahashi ◽  
Naohiro Tomita ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Risk Factor ◽  
Surgical Site Infection ◽  
Restorative Proctocolectomy ◽  
Odds Ratio ◽  
Standard Procedure ◽  
Univariate Analysis ◽  
Site Infection ◽  
Wound Class ◽  
Mucous Fistula

Abstract Although restorative proctocolectomy is recognized as a standard procedure for ulcerative colitis, infectious complications after surgery cannot be disregarded. The aim of this study was to define predictors of surgical site infection (SSI) in urgent/emergent surgery for ulcerative colitis. We performed prospective SSI surveillance for 90 consecutive patients. Possible risk factors were analyzed by logistic regression analyses. Incidences of incisional SSI (i-SSI) and organ/space SSI were 31.1% and 6.9%, respectively, and increased significantly with higher wound class (P &lt; 0.01). Multivariate analysis showed wound class ≥3 as an independent risk factor for i-SSI. In univariate analysis, although the mucous fistula procedure was a risk factor for i-SSI (odds ratio, 3.45; P &lt; 0.01), Hartmann procedure also represented a risk factor for o-SSI (odds ratio, 12.8; P &lt; 0.01). Urgent restorative proctocolectomy for patients without high wound class and emergent total colectomy with mucous fistula for patients with high wound class appear to represent feasible options.

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