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Impact of the extraction-site location on wound infections after laparoscopic colorectal resection.

Authors :
Benlice C
Stocchi L
Sapci I
Gorgun E
Kessler H
Liska D
Steele SR
Delaney CP
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