Rate of Organ Space Infection Is Reduced with the Use of an Air Leak Test During Major Hepatectomies.

Autor: Tran Cao, H., Phuoc, V., Ismael, H., Denbo, J., Passot, G., Yamashita, S., Conrad, C., Aloia, T., Vauthey, J., Tran Cao, H S, Denbo, J W, Aloia, T A, Vauthey, J N
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Zdroj: Journal of Gastrointestinal Surgery; Jan2017, Vol. 21 Issue 1, p85-93, 9p
Abstrakt: Background: Organ/space surgical site infections (OSIs) constitute an important postoperative metric. We sought to assess the impact of a previously described air leak test (ALT) on the incidence of OSI following major hepatectomies.Methods: A single-institution hepatobiliary database was queried for patients who underwent a major hepatectomy without biliary-enteric anastomosis between January 2009 and June 2015. Demographic, clinicopathologic, and intraoperative data-including application of ALT-were analyzed for associations with postoperative outcomes, including OSI, hospital length of stay (LOS), morbidity and mortality rates, and readmission rates.Results: Three hundred eighteen patients were identified who met inclusion criteria, of whom 210 had an ALT. ALT and non-ALT patients did not differ in most disease and treatment characteristics, except for higher rates of trisegmentectomy among ALT patients (53 vs. 34 %, p = 0.002). ALT patients experienced lower rates of OSI and 90-day morbidity than non-ALT patients (5.2 vs. 13.0 %, p = 0.015 and 24.8 vs. 40.7 %, p = 0.003, respectively). In turn, OSI was the strongest independent predictor of longer LOS (OR = 4.89; 95 % CI, 2.80-6.97) and higher rates of 30- (OR = 32.0; 95 % CI, 10.9-93.8) and 45-day readmissions (OR = 29.4; 95 % CI, 10.2-84.6).Conclusions: The use of an intraoperative ALT significantly reduces the rate of OSI following major hepatectomy and may contribute to lower post-discharge readmission rates. [ABSTRACT FROM AUTHOR]
Databáze: Complementary Index
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