Henry P Schoonyoung, MD1, Andrew R Helber, AB1, Barath Krishnan, MD2, Gerald J Marks, MD1, John H Marks, MD1. 1Lankenau Medical Center, Marks Colorectal Surgical Associates, 2Lankenau Medical Center
Surgical site infection (SSI) is common after colorectal surgery. With superficial SSI rates ranging from 5–30%, we hypothesize that performing laparoscopic procedures using a strict clean and dirty technique further reduces the risk of SSI.
We analyzed all laparoscopic colorectal procedures performed on a prospectively maintained database for colorectal procedures retrospectively. 2067 patients were analyzed over a 20-year period from 2/1996-5/2016. Surgeries were performed using the clean and dirty technique. We defined superficial-SSI as an infection in the subcutaneous tissue without abscess, deep-SSI as an abdominal wall abscess, and organ space-SSI as an abdominal abscess, leak, or peritonitis. SSI rate with superficial, deep, and organ space, anastomotic leak, abscess, and fistula were analyzed by: age, sex, BMI, OR-time, preoperative radiation, transfusion, mortality, type of case(abdominal/pelvic), and LOS. Student’s t-test was performed.
49.8% were male. 24.1% received preoperative radiotherapy. 3% received transfusions. The conversion rate was 2.95%. Averages of the following were computed: age 61(16-95), BMI 27.1, EBL 189cc, OR-time 270min, LOS 5.8days, largest incision 4.9cm, follow-up 28.7mos.
SSI=4.69%(n=97), superficial-SSI=1.26%(n=26), deep-SSI=0.15%(n=3), organ space-SSI=3.67%(n=76), anastomotic leak=1.35%(n=28), and abdominal abscess/fistula=2.3%(n=48). There was a statistically significant difference in SSI for males, preoperative radiotherapy, increased EBL, increased OR-time, and LOS. There was no significant difference in perioperative mortality, age, BMI, transfusion rate, conversion rate, mortality, or type of case, abdominal/pelvic.
Laparoscopic colorectal surgery using a clean and dirty technique is associated with a much lower superficial-SSI rate compared to the literature in addition to lower overall SSI rate.
|Length of Stay(≤4/>4 days)||1041/1026||50.4/49.6||
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 80356
Program Number: P183
Presentation Session: Poster (Non CME)
Presentation Type: Poster