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Infections in 346 consecutive video-assisted thoracoscopic procedures
Francesca Rovera1, Andrea Imperatori, Pietro Militello
1Center for Thoracic Surgery, University of Insubria, Ospedale di Circolo di Varese, Varese, Italy.
Surgical Infections
|May 15, 2003
Summary
Postoperative infections are infrequent after video-assisted thoracoscopic surgery (VATS). Patients with chronic obstructive pulmonary disease (COPD) face a higher risk of surgical site infections following VATS procedures.
Area of Science:
- Thoracic Surgery
- Minimally Invasive Procedures
- Infection Control
Background:
- Postoperative infections following video-assisted thoracoscopic surgery (VATS) are infrequently studied concerning risk factors.
- Understanding these risk factors is crucial for improving patient outcomes in minimally invasive thoracic procedures.
Purpose of the Study:
- To identify preoperative risk factors associated with postoperative infections in patients undergoing VATS.
- To compare infection rates between different types of VATS procedures, specifically lung wedge resection versus pleural or mediastinal mass biopsy.
Main Methods:
- A prospective study evaluated 346 patients undergoing VATS, divided into lung wedge resection and pleural/mediastinal biopsy groups.
- Preoperative infection risk parameters including hemoglobin, albumin, lymphocyte count, and COPD (FEV(1) <70%) were recorded.
- Postoperative infections (surgical site infection, pneumonia, empyema) within 30 days were monitored.
Main Results:
- The overall incidence of postoperative infections was 4.9%, with a surgical site infection rate of 1.7%.
- No significant difference in infection rates was observed between lung wedge resection and pleural/mediastinal biopsy groups.
- Chronic obstructive pulmonary disease (COPD), defined as FEV(1) <70%, was the only significant predictor of increased surgical site infection risk (p < 0.05).
Conclusions:
- Minimally invasive VATS procedures are associated with a low wound infection rate (1.7%).
- COPD is identified as a significant risk factor for postoperative surgical site infections in VATS patients.
- Antibiotic prophylaxis is recommended for patients with COPD undergoing VATS for lung wedge resections and pleural/mediastinal biopsies to prevent surgical site infections.