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Article: Impact of laparoscopic colorectal resection on surgical site infection

TitleImpact of laparoscopic colorectal resection on surgical site infection
Authors
Issue Date2009
PublisherLippincott Williams & Wilkins. The Journal's web site is located at http://www.annalsofsurgery.com
Citation
Annals Of Surgery, 2009, v. 249 n. 1, p. 77-81 How to Cite?
AbstractObjectives: This study aimed to identify the risk factors of surgical site infection (SSI) in elective colorectal resection and the strategy for prevention of SSI in modern era of colorectal surgery. Background: The practice of colorectal surgery has undergone remarkable evolution recently because of application of laparoscopic resection. This could affect SSI in colorectal patients. An updated investigation of SSI under current practice of colorectal surgery would provide valuable information. Methods: This was a prospective study of SSI on 1011 patients, who had elective colorectal resection in a university teaching hospital, during January 2002 to December 2006. Standard definition and postoperation follow-up of SSI were adopted through collaboration between surgeons and wound surveillance program of Infection Control Unit. Risk factors of SSI were evaluated. Logistic regression was used to perform multivariate analysis and decide independent risk factors of SSI. Results: The overall rate of incisional SSI and organ/space SSI was 4.8% and 1.7%, respectively. Rate of incisional SSI in open and laparoscopic colorectal resection was 5.7% and 2.7%, respectively. Anastomotic leakage was the only factor that predicted organ/space SSI (P < 0.01). Independent risk factors of incisional SSI included blood transfusion [P = 0.047; odds ratio (OR) = 2.43; 95% confidence interval (CI): 1.0-5.9], anastomotic leakage (P < 0.01; OR = 6.5; 95% CI: 2.3-18.6), and open colorectal resection (P = 0.037; OR = 2.36; 95% CI: 1.1-5.3). Conclusion: In current practice of colorectal surgery, operative factors are more important than patient factors for SSI. Good surgical technique to reduce anastomotic leakage and reduce blood transfusion has paramount importance in SSI prevention. Laparoscopic surgery was associated with reduction of rate of SSI by more than 50% when compared with open surgery and would have a strong impact on the prevention of surgical infection. © 2009 by Lippincott Williams & Wilkins.
Persistent Identifierhttp://hdl.handle.net/10722/59959
ISSN
2015 Impact Factor: 8.569
2015 SCImago Journal Rankings: 4.503
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorPoon, JTen_HK
dc.contributor.authorLaw, WLen_HK
dc.contributor.authorWong, IWen_HK
dc.contributor.authorChing, PTen_HK
dc.contributor.authorWong, LMen_HK
dc.contributor.authorFan, JKMen_HK
dc.contributor.authorLo, OSHen_HK
dc.date.accessioned2010-05-31T04:00:55Z-
dc.date.available2010-05-31T04:00:55Z-
dc.date.issued2009en_HK
dc.identifier.citationAnnals Of Surgery, 2009, v. 249 n. 1, p. 77-81en_HK
dc.identifier.issn0003-4932en_HK
dc.identifier.urihttp://hdl.handle.net/10722/59959-
dc.description.abstractObjectives: This study aimed to identify the risk factors of surgical site infection (SSI) in elective colorectal resection and the strategy for prevention of SSI in modern era of colorectal surgery. Background: The practice of colorectal surgery has undergone remarkable evolution recently because of application of laparoscopic resection. This could affect SSI in colorectal patients. An updated investigation of SSI under current practice of colorectal surgery would provide valuable information. Methods: This was a prospective study of SSI on 1011 patients, who had elective colorectal resection in a university teaching hospital, during January 2002 to December 2006. Standard definition and postoperation follow-up of SSI were adopted through collaboration between surgeons and wound surveillance program of Infection Control Unit. Risk factors of SSI were evaluated. Logistic regression was used to perform multivariate analysis and decide independent risk factors of SSI. Results: The overall rate of incisional SSI and organ/space SSI was 4.8% and 1.7%, respectively. Rate of incisional SSI in open and laparoscopic colorectal resection was 5.7% and 2.7%, respectively. Anastomotic leakage was the only factor that predicted organ/space SSI (P < 0.01). Independent risk factors of incisional SSI included blood transfusion [P = 0.047; odds ratio (OR) = 2.43; 95% confidence interval (CI): 1.0-5.9], anastomotic leakage (P < 0.01; OR = 6.5; 95% CI: 2.3-18.6), and open colorectal resection (P = 0.037; OR = 2.36; 95% CI: 1.1-5.3). Conclusion: In current practice of colorectal surgery, operative factors are more important than patient factors for SSI. Good surgical technique to reduce anastomotic leakage and reduce blood transfusion has paramount importance in SSI prevention. Laparoscopic surgery was associated with reduction of rate of SSI by more than 50% when compared with open surgery and would have a strong impact on the prevention of surgical infection. © 2009 by Lippincott Williams & Wilkins.en_HK
dc.languageengen_HK
dc.publisherLippincott Williams & Wilkins. The Journal's web site is located at http://www.annalsofsurgery.comen_HK
dc.relation.ispartofAnnals of Surgeryen_HK
dc.rightsAnnals of Surgery. Copyright © Lippincott Williams & Wilkins.en_HK
dc.titleImpact of laparoscopic colorectal resection on surgical site infectionen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0003-4932&volume=249&issue=1&spage=77&epage=81&date=2009&atitle=Impact+of+laparoscopic+colorectal+resection+on+surgical+site+infectionen_HK
dc.identifier.emailPoon, JT: tcjensen@hkucc.hku.hken_HK
dc.identifier.emailLaw, WL: lawwl@hkucc.hku.hken_HK
dc.identifier.authorityPoon, JT=rp01603en_HK
dc.identifier.authorityLaw, WL=rp00436en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1097/SLA.0b013e31819279e3en_HK
dc.identifier.scopuseid_2-s2.0-58749097474en_HK
dc.identifier.hkuros157904en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-58749097474&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume249en_HK
dc.identifier.issue1en_HK
dc.identifier.spage77en_HK
dc.identifier.epage81en_HK
dc.identifier.eissn1528-1140-
dc.identifier.isiWOS:000262219300013-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridPoon, JT=7005903722en_HK
dc.identifier.scopusauthoridLaw, WL=7103147867en_HK
dc.identifier.scopusauthoridWong, IW=26022726100en_HK
dc.identifier.scopusauthoridChing, PT=7005847968en_HK
dc.identifier.scopusauthoridWong, LM=26022708100en_HK
dc.identifier.scopusauthoridFan, JKM=23484820100en_HK
dc.identifier.scopusauthoridLo, OSH=6508168045en_HK

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