The association between the increased performance of laparoscopic colon surgery and a reduced risk of surgical site infection

Abstract

Purpose Surgical site infection (SSI) is the most frequently occurring nosocomial infection. Remarkable surgical progress has recently been made in laparoscopic surgery. Therefore, our objective was to investigate the association between increased rates of laparoscopic colon surgery and SSI. Methods We retrospectively investigated SSI surveillance data from July 2003 to December 2015. Two university hospitals and 25 university-affiliated hospitals participated in prospective SSI surveillance. Univariate and multivariate analyses were performed to detect significant associations. Results We investigated 9655 colon surgeries. The year in which surgery was performed was significantly associated with the SSI rate ( p = 0.0381). The rate of laparoscopic surgery gradually increased during the study period, and by 2012 it was routinely used for > 50% of colon surgeries. Laparoscopic surgery became a significant factor associated with reduced SSI rates compared with conventional open surgery once the performance rate of laparoscopic surgery reached > 50%. Conclusions Increasing rates of laparoscopic colon surgery tended to be associated with a reduction in the SSI risk after surgical treatment of colonic disease. The results of this study might encourage surgeons to view laparoscopic surgical techniques as an evidence-based approach for reducing the risk of SSI. Electronic supplementary material The online version of this article (10.1007/s00595-019-1760-1) contains supplementary material, which is available to authorized users.

<p>Downregulation of miR-216a-5p by long noncoding RNA PVT1 suppresses colorectal cancer progression via modulation of YBX1 expression</p>

“…Despite the rapid development of various therapeutic approaches such as endoscopic, laparotomic or laparoscopic removal of tumor, chemotherapy, radiotherapy, or immunotherapy, the prognosis of patients with CRC remains unsatisfactory. Therefore, a detailed study of the underlying mechanisms of CRC progression is required to develop more precise diagnostic methods and effective treatments 3,4…”

Single‐incision laparoscopic colectomy for ascending colon tumor with relapsing polychondritis

“…The use of steroids generally creates a high surgical risk, leading to delayed wound healing such as anastomosis leakage and surgical site infection. 5 In this case, a relatively high volume of steroids was used, and these complications were considered highly likely. However, without complications such as anastomosis leakage and surgical site infection, the postoperative course was F I G U R E 3 An EZ Access Port (Hakkou Shoji, Nagano, Japan) was inserted through a 30-mm transumbilical incision.…”

“…The use of steroids generally creates a high surgical risk, leading to delayed wound healing such as anastomosis leakage and surgical site infection . In this case, a relatively high volume of steroids was used, and these complications were considered highly likely.…”

Effect of laparoscopic surgery on the risk for surgical site infections in colorectal resection: results from the Health Insurance Review & Assessment Service Database

“…Over the past 2 decades, with the widespread application of Lap-CRS and with the effort for proper application of prophylactic antibiotics, the incidence of SSI has decreased (2.7%-8.8%) [6,10]. A study by Kagawa et al [15] demonstrated that the widespread use of laparoscopic surgery to treat colon disease may confer protection against SSI. The contributing factors associated with the lower incidence of SSI with laparoscopic surgery are believed to be the smaller surgical incision, decreased tissue trauma, and elimination of mechanical retraction of the abdominal wall [12].…”

“…To date, several studies have reported that Lap-CRS has favorable short-term outcomes such as a reduction in the incidence of SSI, hospital LOS, and medical costs [2,4,6,14,15]. Currently, there have been no studies with a large number of patients in multicenter analyses regarding the relationships between the type of surgery and SSI, hospital LOS, and medical costs in Korea.…”