Preoperative oral care and effect on postoperative complications after major cancer surgery

Ishimaru, Miho; Matsui, Hiroki; Ono, Sachiko; Hagiwara, Yasuhiro; Morita, Kojiro; Yasunaga, Hideo

doi:10.1002/bjs.10915

Cited by 106 publications

(101 citation statements)

References 44 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Our current ndings are incompatible with previous reports investigating the effectiveness of preoperative oral hygiene care for patients undergoing esophagectomy (10,11,12); evidence of its effectiveness has also been reported by several studies in elds of surgery other than esophagectomy (17,18). The discrepancy might be explained in part due to differences in preoperative intervention methods.…”

Section: Discussioncontrasting

confidence: 99%

The Effectiveness and Impact of Preoperative Dental Hygiene Care on the Incidence of Postoperative Pneumonia after Esophagectomy: An Interventional Prospective Study

Mori

Jimbo

Aikou

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: Postoperative pneumonia is a major cause of postoperative mortality after esophagectomy. Preoperative oral hygiene care is reportedly effective to prevent pulmonary complications after esophagectomy. Methods: Since April 2012, we have included preoperative oral hygiene in the standard perioperative care regimen for esophagectomy and have accumulated data on 188 consecutive patients undergoing esophagectomy to evaluate oral hygiene care’s effectiveness. To determine basic (i.e. non-clinical) and clinical effects of preoperative oral care, we prospectively observed the incidence rate of postoperative pneumonia and accumulated perioperative culture study and oral bacteria count data on these 188 patients. One hundred five patients studied in our previous retrospective study from 2009 to 2012 were enrolled as a historical control.Results: In the current study’s patients, no significant reduction of postoperative pneumonia was observed compared to the historical control (30 out of 188 vs. 21 out of 105, P=0.423). Perioperative culture studies showed significantly decreased positivity in preoperative oral samples (11% in dental plaque and 13% in tongue coating) but no such decrease was observed in studies of postoperative gastric juice and endotracheal sputum. With the exception of postoperative endotracheal sputum, perioperative cultures had few of the pathogenic microbes identified in pneumonia patients. In the analyses of oral bacterial count, oral microbial flora were significantly decreased after oral care in both dental plaque (median ratio to before care: 1:0.13, P<0.0001) and tongue coating (median ratio: 1:0.015, P<0.0001); however, only in the dental plaque did the decrease last until the day of the operation (median ratio: 1:0.10, P=0.0008). Logistic regression analysis showed only the bacterial amount in dental plaque on the operation day (P=0.026) to be marginally correlated to the incidence of pneumonia. Conclusions: Although perioperative oral hygiene care had a significant impact on oral bacterial load, its contribution to the prevention of postoperative pneumonia was limited.Trial registration: This study was registered and approved by the institutional review board of The University of Tokyo Hospital: Approval number: 3383, Date: 26th November, 2011

show abstract

Section: Discussioncontrasting

confidence: 99%

The Effectiveness and Impact of Preoperative Dental Hygiene Care on the Incidence of Postoperative Pneumonia after Esophagectomy: An Interventional Prospective Study

Mori

Jimbo

Aikou

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…The present study showed that the oral bacteria count significantly increased immediately after heart surgery, especially in intubated patients, but returned to baseline values several days afterwards. Previous reports have shown that perioperative oral health care could decrease the risk of pneumonia and improve prognosis in gastrointestinal cancer and heart surgery cases [2,3,9], as oral bacteria are nosocomial pneumonia-suspected pathogens [1]. Findings from this study support the notion that increased oral bacteria numbers after surgery may be a risk factor for postoperative pneumonia.…”

Section: Discussionsupporting

confidence: 80%

“…For patients at risk of infectious endocarditis (IE), such as those with acquired valvular disease or receiving an artificial heart valve replacement, dental check-ups and treatment are recommended to prevent odontogenic infection, according to IE prevention guidelines [8]. Therefore, dental intervention prior to surgery is important as it has the potential to reduce the risk of postoperative circulatory and respiratory infections in patients receiving heart valve surgery [8,9].…”

Section: Introductionmentioning

confidence: 99%

Perioperative changes in oral bacteria number in patients undergoing cardiac valve surgery

et al. 2019

View full text Add to dashboard Cite

Perioperative oral care can reduce the risk of postoperative infections. This study examined 1) changes in oral bacteria counts during the perioperative period and 2) differences in bacteria counts in patients with or without endotracheal intubation. 47 patients who visited our hospital dental clinic prior to cardiac valve surgery were prospectively recruited. The number of bacteria on the tongue, tooth surface, and buccal vestibule was measured on the day before and 1, 4, and 7 days after surgery. Oral bacteria counts were statistically compared among time points and between intubation and extubation statuses. The oral bacteria counts on the tooth surface and buccal vestibule significantly increased from the day before surgery to 1 day after surgery, and then decreased from 1 to 4 days after surgery. On the day after surgery, the bacteria counts on the tooth surface and buccal vestibule were significantly higher in the intubated compared with the extubated group. Our findings suggest that the oral bacteria count is elevated just after surgery, especially if the patient has endotracheal intubation, which may increase the risk of aspiration pneumonia. These results highlight the importance of perioperative oral care to prevent postoperative pneumonia.

show abstract

“…Secondly, it was observational and did not include a control group without oral healthcare intervention group. Due to several previous reports on the effects of preoperative oral care on reduction of the risk of postoperative pneumonia (Akutsu et al, ; Bergan, Tura, & Lamas, ; Ishimaru et al, ; Shigeishi et al, ), it is ethically and clinically difficult to construct the study protocol without perioperative intervention. Accordingly, preoperative periodontal treatment was performed for all participants in this study.…”

Section: Discussionmentioning

confidence: 99%

Perioperative changes in knowledge and attitude toward oral health by oral health education

et al. 2019

View full text Add to dashboard Cite

Objectives: Perioperative oral health care can prevent postoperative complications, but it is also important to maintain oral health afterward to avoid later adverse events.This study examined (a) the relationship between knowledge and attitude toward oral health (KAOH) and oral/periodontal status (OPS) in patients receiving surgery, and (b) the changes in KAOH by perioperative oral health care and education. Methods:Patients receiving surgery who visited our hospital's dental clinic beforehand were prospectively recruited. All participants received oral health care and education. In questionnaires assessing KAOH before and after surgery, respondent answers were generally classified as positive or negative. OPS was assessed before surgery. Associations between KAOH and OPS and perioperative changes in KAOH were statistically tested. Results:A total of 507 patients answered the questionnaire before surgery, among whom 324 patients also completed it afterward. Preoperative OPS was significantly worse in the negative than in the positive KAOH group. Positive answers for KAOH increased significantly from 68.6% to 92.2% during the perioperative period. Conclusions:We found that patients with poor KAOH also had poor OPS, but KAOH could be improved by perioperative oral health care and education, suggesting that perioperative oral health management could improve oral health knowledge and attitudes. K E Y W O R D Sattitude, knowledge, motivation, oral education, oral health, perioperative oral management

show abstract

Preoperative oral care and effect on postoperative complications after major cancer surgery

Abstract: Preoperative oral care by a dentist significantly reduced postoperative complications in patients who underwent cancer surgery.

Cited by 106 publications

References 44 publications

The Effectiveness and Impact of Preoperative Dental Hygiene Care on the Incidence of Postoperative Pneumonia after Esophagectomy: An Interventional Prospective Study

The Effectiveness and Impact of Preoperative Dental Hygiene Care on the Incidence of Postoperative Pneumonia after Esophagectomy: An Interventional Prospective Study

Perioperative changes in oral bacteria number in patients undergoing cardiac valve surgery

Perioperative changes in knowledge and attitude toward oral health by oral health education

Contact Info

Product

Resources

About