Tetsuo Ishizaki, Kenji Katsumata, Masanobu Enomoto, Takaaki Matsudo, Hiroshi Kuwabara, Akihiko Tsuchida. Tokyo Medical University
Purpose: Intracorporeal anastomosis (IA) are commonly created during laparoscopic colectomy. However, there is concern regarding the possibility of intra-abdominal infections caused by the leakage of digestive liquid. In this study, we evaluated the bacterial contamination in IA during laparoscopic colectomy.
Materials and Methods: A total of 29 patients who underwent laparoscopic colectomy with IA at Tokyo Medical University Hospital between January 2014 and April 2016 were included in the study. In each patient, after perfoming of the IA, the abdominal cavity surrounding the anastomosis was washed with 300 mL of saline, and 10 mL of the saline for culture analysis. In addition, post-operative body temperatures (BT) and C-reactive protein (CRP) levels of the study subjects were compared with IA and 35 patients who underwent laparoscopic colectomy with extracorporeal anastomosis (EA) during the same period.
Results: Pathogenic bacteria were present in 13 patients (44.8%). The identified bacteria, listed in order of their pathogenicity (from the most pathogenic), were Pseudomonas aeruginosa, Escherichia coli, Streptococcus and Anaerobic bacteria. Subjects in the IA group had higher BT than those in the EA group 1 day after surgery (100.4°F vs. 99.9°F; P = 0.03), as well as in 1 day after surgery, had higher CRP levels both 1 day after surgery (5.9 mg/dL vs. 3.3 mg/dL; P = 0.01) and 3 days after surgery (7.4 mg/dL vs. 5.7 mg/dL; P = 0.04). The lengths of hospital stays were similar in the IA and EA groups (11 days vs. 10 days; P = 0.67).
Conclusion: Intra-abdominal infection may occur owing to the leakage of digestive bacteria during laparoscopic colectomy with IA. We hence conclude that methods should be designed to prevent infection during the IA procedure.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 79004
Program Number: P237
Presentation Session: Poster (Non CME)
Presentation Type: Poster