Related Experiment Videos
[Clinical study of surgical site infection following portless endoscopic urological surgery (PLES)]
Manabu Tadokoro1, Hitoshi Masuda, Tetsuo Okuno
1Department of Urology and Reproductive Medicine, Graduate School Tokyo Medical and Dental University.
Abstract:
We investigated the clinical risk factors and bacteriological examination for surgical site infection (SSI) in 144 portless endoscopic surgeries consisting of 66 clean and 78 clean-contaminated surgeries in urological diseases from April 2000 to December 2001. There were no cases of SSI in the clean surgeries. SSI occurred in 5 cases (3.5%) of clean-contaminated surgeries including total cystectomy and ileal conduit in 4 cases and total prostatectomy in 1 case. Multivariate statistical studies revealed that usage of ileum during operation and preoperative hypo-albuminemia were significant risk factors for SSI. Gram-negative rods and anaerobic bacteria were isolated from the operative wound in the total cystectomy and ileal conduit, suggesting that SSI in the operation with usage of the ileum was partially derived from contamination with endogenous bacteria, while, normal flora of the skin in the wound did not cause any post-operative SSI.
Insights
Surgical site infections (SSI) were studied in 144 endoscopic urological surgeries. Usage of the ileum and low preoperative albumin levels were identified as key risk factors for SSI in clean-contaminated procedures.
Area of Science:
- Urology
- Infectious Disease
- Surgical Oncology
Context:
- Portless endoscopic surgery is a minimally invasive technique used in urological procedures.
- Surgical site infections (SSI) are a potential complication following any surgical procedure.
- Understanding risk factors for SSI is crucial for improving patient outcomes.
Purpose:
- To investigate clinical risk factors and bacteriological causes of surgical site infection (SSI) in portless endoscopic urological surgeries.
- To differentiate SSI causes between clean and clean-contaminated surgical procedures.
Summary:
- A study of 144 portless endoscopic urological surgeries (66 clean, 78 clean-contaminated) found no SSIs in clean surgeries.
- SSI occurred in 3.5% of clean-contaminated surgeries (5 cases).
- Multivariate analysis identified ileum usage during surgery and preoperative hypoalbuminemia as significant SSI risk factors. Bacteriological examination revealed Gram-negative rods and anaerobic bacteria in cases involving ileum usage, suggesting endogenous bacterial contamination.
Impact:
- Identifies specific risk factors (ileum usage, hypoalbuminemia) for SSI in endoscopic urological surgery.
- Highlights the importance of endogenous bacterial flora in SSI development when the ileum is used.
- Provides evidence-based insights for preventing SSI in urological endoscopic procedures.