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Impact of the extraction-site location on wound infections after laparoscopic colorectal resection.
- Source :
-
American journal of surgery [Am J Surg] 2019 Mar; Vol. 217 (3), pp. 502-506. Date of Electronic Publication: 2018 Oct 29. - Publication Year :
- 2019
-
Abstract
- Background: The purpose of this study was to determine the impact of the incision used for specimen extraction on wound infection during laparoscopic colorectal surgery.<br />Methods: All patients undergoing elective laparoscopic colorectal resection in a single specialized department from 2000 to 2011 were identified from a prospectively maintained institutional database. Specific extraction-sites and other relevant factors associated with wound infection rates were evaluated with univariate and multivariate analyses.<br />Results: 2801 patients underwent specimen extraction through infra-umbilical midline (N = 657), RLQ/LLQ (N = 388), stoma site (N = 58), periumbilical midline (N = 629), Pfannenstiel (N = 789) and converted midline (N = 280). The overall wound infection rate was 10% and was highest in converted midline (14.6%) and Pfannenstiel (11.4%) incisions, while the lowest rate was associated with RLQ/LLQ (N = 13, 3.3%). Independent factors associated with wound infection were increased BMI (p < 0.001), extraction site location (p = 0.006), surgical procedure (p = 0.020, particularly left-sided colectomy and total proctocolectomy), diagnosis (p < 0.001, particularly sigmoid diverticulitis and inflammatory bowel disease), intraabdominal adhesions (p = 0.033) and intrabdominal rather than pelvic procedure (p = 0.005).<br />Conclusions: A RLQ/LLQ extraction site is associated with the most reduced risk of wound infection in laparoscopic colorectal surgery.<br /> (Copyright © 2018 Elsevier Inc. All rights reserved.)
Details
- Language :
- English
- ISSN :
- 1879-1883
- Volume :
- 217
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- American journal of surgery
- Publication Type :
- Academic Journal
- Accession number :
- 30390938
- Full Text :
- https://doi.org/10.1016/j.amjsurg.2018.10.034