Efficacy of perioperative oral care management in the prevention of surgical complications in 503 patients after pancreaticoduodenectomy for resectable malignant tumor: A multicenter retrospective analysis using propensity score matching.

Autor: Yamguchi T; Department of Preventive Dentistry, Kagoshima University, Japan. Electronic address: yamatai@dent.kagoshima-u.ac.jp., Mori K; Division of Clinical Engineering, Kagoshima University Hospital, Japan., Kojima Y; Department of Dentistry and Oral Surgery, Kansai Medical University, Japan., Hasegawa T; Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Japan., Hirota J; Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Japan., Akashi M; Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Japan., Soutome S; Department of Oral Health, Nagasaki University Graduate School of Biomedical Sciences, Japan., Yoshimatsu M; Oral Management Center, Nagasaki University Hospital, Japan., Nobuhara H; Department of Dentistry, Hiroshima Prefectural Hospital, Japan., Matsugu Y; Department of Gastroenterological, Breast and Transplant Surgery, Hiroshima Prefectural Hospital, Japan; Department of Clinical Nutrition, Hiroshima Prefectural Hospital, Japan., Kato S; Department of Oral and Maxillofacial Surgery, Nagoya City University Graduate School of Medical Sciences, Japan., Shibuya Y; Department of Oral and Maxillofacial Surgery, Nagoya City University Graduate School of Medical Sciences, Japan., Kurita H; Department of Dentistry and Oral Surgery, Shinshu University School of Medicine, Japan., Yamada SI; Department of Dentistry and Oral Surgery, Shinshu University School of Medicine, Japan; Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Academic Assembly, University of Toyama, Japan., Nakahara H; Department Oral and Maxillofacial Surgery, Osaka Metrpolitan University Graduate School of Medicine, Japan.
Jazyk: angličtina
Zdroj: Surgery [Surgery] 2024 Apr; Vol. 175 (4), pp. 1128-1133. Date of Electronic Publication: 2023 Dec 06.
DOI: 10.1016/j.surg.2023.11.008
Abstrakt: Background: Pancreaticoduodenectomy has been associated with a high mortality rate and significant postoperative morbidity. Recently, perioperative oral care management has been reported to be effective in preventing postoperative pneumonia and surgical site infection. In this study, we examined the effect of perioperative oral care management in reducing complications after pancreaticoduodenectomy, including surgical site infection.
Methods: This retrospective multicenter study included 503 patients who underwent pancreaticoduodenectomy at 8 facilities between January 2014 and December 2016. Among these, 144 received perioperative oral management by dentists and dental hygienists (oral management group), whereas the remaining 359 did not (control group). The oral care management program included oral health instructions, removal of dental calculus, professional mechanical tooth cleaning, removal of tongue coating, denture cleaning, instructions for gargling, and tooth extraction. The participants were matched using propensity scores to reduce background bias. Various factors were examined for correlation with the development of complications.
Results: The incidence of organ/space surgical site infection was significantly lower in the oral management group than in the control group (8.0% vs 19.6%, P = .005). Multivariable logistic regression analysis revealed that hypertension and lack of perioperative oral management were independent risk factors for organ/space surgical site infection. Lack of perioperative oral management had an odds ratio of 2.847 (95% confidence interval 1.335-6.071, P = .007).
Conclusion: Perioperative oral care management reduces the occurrence of surgical site infections after pancreaticoduodenectomy and should be recommended as a strategy to prevent infections in addition to antibiotic use.
(Copyright © 2023. Published by Elsevier Inc.)
Databáze: MEDLINE
Externí odkaz: