The evolution of laparoscopy in abdominal surgery: A meta-analysis of the effect on infectious outcomes

Sanabria, Álvaro; Vega, Valentín; Domínguez-Torres, Luis Carlos; Espitia, Érik; Serna, Adriana; Osorio, Camilo

doi:10.3109/13645706.2013.854808

Cited by 6 publications

(5 citation statements)

References 29 publications

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“…This finding was described in previous research work where scope use significantly reduced SSI rates. 7 , 27 , 28 A review of the literature showed scarce research evidence on SSIs following SB surgeries; most researchers had studied SSIs of either the large bowel alone or in combination with SB surgeries. 10 , 29 , 30 The present study showed that the incidence of SSIs following SB surgery was 10.8%.…”

Section: Discussionmentioning

confidence: 99%

“…This finding was concordant with results from other research. 28 A possible explanation for the higher incidence of SSIs in emergency surgeries could be attributed to inadequate preoperative preparation, as these surgeries usually take place beyond normal clinical working hours. Therefore, it is of high importance to emphasize the management of emergency surgeries.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Benchmarking for surgical site infections among gastrointestinal surgeries and related risk factors: multicenter study in Kuwait

Hamza¹,

Salama²,

Morsi³

et al. 2018

IDR

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PurposeTo measure surgical site infection (SSI) rates among gastrointestinal surgeries and to identify the associated risk factors.Patients and methodsWe conducted a multicenter, retrospective, surveillance-based study of adults undergoing gastric, colon, and small bowel (SB) procedures from January to December 2016. Univariate and multivariate analyses were conducted to determine the predictive variables in each surgery.ResultsIn total, 71 of 2,099 patients developed SSI – 0.8%, 19.8%, and 10.8% following gastric, colon, and SB surgeries, respectively. In gastric surgery, the risk factors identified by univariate analysis were age, duration, wound class, risk index, emergency, and scope use (P<0.05). Logistic regression analysis revealed that the laparoscopic approach was the only significant predictor, with an inverse relationship of SSI rate vs open gastric surgery (P<0.05). Prolonged duration was a significant risk factor for developing SSI in colon surgery, and emergency was a significant risk for development of SSI in SB surgery. Gram-negative bacilli were the main causative pathogens, with a high percentage of multidrug-resistant organisms.ConclusionVariances in SSI rates and risk factors among gastric, colon, and SB surgery were detected. The use of an endoscope in gastric surgeries exhibited a protective effect against the development of SSI. The reduction of the SSI rate can be achieved by targeted preventive interventions for the identified risk factors.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Benchmarking for surgical site infections among gastrointestinal surgeries and related risk factors: multicenter study in Kuwait

Hamza¹,

Salama²,

Morsi³

et al. 2018

IDR

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“…As shown in Table 1 , the incidence of SSI in emergency surgery cases was higher than in elective surgery cases (8.4% versus 2.5%, respectively), which is in accordance with other studies. 21 , 22 Patients with acute abdominal pain account for the majority of emergency surgeries, and are at high perioperative risk for SSI because of the infected operation, especially at the preoperative infection lesions. On the other hand, most of the emergency surgeries were carried out beyond normal duty working hours and inadequate preoperative preparation might be a possible explanation for the higher incidence of SSI.…”

Section: Discussionmentioning

confidence: 99%

Risk factors for surgical site infection in a teaching hospital: a prospective study of 1,138 patients

Keping¹,

Li²,

Kong³

et al. 2015

PPA

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BackgroundThe purpose of this study was to identify risk factors for surgical site infection (SSI) in a teaching hospital.MethodsA prospective study was initiated to investigate risk factors for SSI at a university-affiliated tertiary care center from July 2013 to December 2014. The chi-square test for categorical variables was used to determine the significance of association, whereas the multivariate logistic regression model was used to examine independent risk factors for SSI.ResultsA total of 1,138 patients met the inclusion criteria, in whom 36 cases of infection occurred during the hospitalization period and two cases occurred after discharge. Univariate analysis showed that SSI was associated with the type of operation, wound classification, volume of blood loss, blood transfusion, American Society of Anesthesiology score before surgery, risk index, duration of surgery, diabetes, cancer, gastrointestinal catheter, urinary catheter, postoperative drainage, and preprocedural white blood cell count. Multivariate analysis identified six independent parameters correlating with the occurrence of SSI: diabetes (odds ratio [OR] 6.400; 95% confidence interval [CI] 2.582–15.866; P=0.000); cancer (OR 2.427; 95% CI 1.028–5.732; P=0.043); preprocedural white blood cell count more than 10×109/L (OR 6.988; CI 3.165–15.425; P=0.000); wound classification (clean contaminated [OR: 7.893; CI: 2.244–27.762; P=0.001]; contaminated [OR: 7.031; CI: 1.652–29.922; P=0.008]; dirty [OR: 48.778; CI: 5.418–439.164; P=0.001]); operative duration more than 120 minutes (OR 4.289; CI 1.773–10.378; P=0.001); and postoperative drainage (OR 3.957; CI 1.422–11.008; P=0.008).ConclusionOur data suggest that all these risk factors could be regarded as potential indicators of SSI and that relevant preventive measures should be taken to reduce SSI and improve patient outcomes.

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“…La visión de cirugía sin estrés y sin dolor podría convertirse en realidad con mayor investigación de esta prometedora estrategia. Cabe destacar que algunos elementos del fast-track son usados de rutina y aisladamente por algunos cirujanos, sin la aplicación de todo el protocolo (por ejemplo, retiro temprano de sondas o drenajes, o ayunos cortos y dieta temprana) 32,33 . Sin embargo, es la implementación simultánea de todas las herramientas de la estrategia, las que pueden acelerar la recuperación posquirúrgica.…”

Section: Diferencia De Medias Sopesadas Entre Cuidado Convencional (C...unclassified

La recuperación posoperatoria acelerada (fast track) disminuye la estancia hospitalaria en cirugía gastrointestinal alta: revisión sistemática de la literatura

Jimenez

Domínguez

2015

Rev Colomb Cir

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Introducción. Los protocolos de la cirugía con recuperación acelerada (fast-track surgery) han demostrado disminución de la estancia hospitalaria y los costos médicos en cirugía colorrectal. La evidencia sobre su aplicación en cirugía general es escasa si se compara con otras especialidades quirúrgicas. En este estudio se revisa la evidencia científica sobre la estrategia fast-track en cirugía gastrointestinal alta. Métodos. Se revisaron PubMed y Medline con el término “fast track surgery” y “ERAS surgery”. Se incluyeron estudios clínicos controlados de asignación aleatoria que contaran con un grupo de control de pacientes con cuidado convencional. Se excluyeron trabajos no relacionados con cirugía gastrointestinal alta. Se analizaron las diferencias de medias sopesadas, tomando como puntos finales la estancia hospitalaria, la morbilidad, la mortalidad y la rehospitalización. Resultados. Cinco estudios clínicos de asignación aleatoria cumplieron con los criterios de inclusión. Cuatro estudios de gastrectomías y uno de perforación de úlcera duodenal. De un total de 385 pacientes, se compararon 197 (51 %) en el grupo con cuidado convencional y 188 (49 %) en grupo con fast-track. Al comparar el cuidado convencional con el fast-track, la estancia hospitalaria fue de 7,5 Vs. 5,7 días, (p=0,019), y la morbilidad, de 22 % Vs. 14 % (p=0,017), respectivamente. No se obtuvieron diferencias significativas en la mortalidad (p=0.347) ni en las rehospitalizaciones (p=0.954) entre los dos grupos. Conclusión. La estrategia fast-track disminuye la estancia hospitalaria, y puede implementarse en forma segura en pacientes que requieren cirugía gastrointestinal alta, sin incrementar la morbilidad, la mortalidad ni las rehospitalizaciones.

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The evolution of laparoscopy in abdominal surgery: A meta-analysis of the effect on infectious outcomes

Abstract: Laparoscopic surgery significantly decreases the risk of superficial SSI but does not affect the risk of organ/space SSI. Experience with technique improves outcomes.

Cited by 6 publications

References 29 publications

Benchmarking for surgical site infections among gastrointestinal surgeries and related risk factors: multicenter study in Kuwait

Benchmarking for surgical site infections among gastrointestinal surgeries and related risk factors: multicenter study in Kuwait

Risk factors for surgical site infection in a teaching hospital: a prospective study of 1,138 patients

La recuperación posoperatoria acelerada (fast track) disminuye la estancia hospitalaria en cirugía gastrointestinal alta: revisión sistemática de la literatura

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