Surgical site infection rates following laparoscopic urological procedures
Arvin K George1, Arun K Srinivasan, Jane Cho
1Smith Institute for Urology, Hofstra University School of Medicine of the North Shore-LIJ Health System, Long Island, New York 11040, USA. arvinkgeorge@gmail.com
Purpose:
Surgical site infections have been categorized by the Centers for Medicare and Medicaid Services as "never events". The incidence of surgical site infection following laparoscopic urological surgery and its risk factors are poorly defined. We evaluated surgical site infection following urological laparoscopic surgery and identified possible factors that may influence occurrence.
Materials And Methods:
Patients who underwent transperitoneal laparoscopic procedures during a 4-year period by a single laparoscopic surgeon were retrospectively reviewed. Surgical site infections were identified postoperatively and defined using the Centers for Disease Control criteria. Clinical parameters, comorbidities, smoking history, preoperative urinalysis and culture results as well as operative data were analyzed. Nonparametric testing using the Mann-Whitney U test, multivariable logistic regression and Spearman's rank correlation coefficient were used for data analysis.
Results:
In 556 patients undergoing urological laparoscopic procedures 14 surgical site infections (2.5%) were identified at mean postoperative day 21.5. Of the 14 surgical site infections 10 (71.4%) were located at a specimen extraction site. Operative time, procedure type and increasing body mass index were significantly associated with the occurrence of surgical site infections (p = 0.007, p = 0.019, p = 0.038, respectively), whereas history of diabetes mellitus (p = 0.071) and intraoperative transfusion (p = 0.053) were found to trend toward significance. Age, gender, positive urine culture, steroid use, procedure type and smoking history were not significantly associated with surgical site infection. Body mass index and operative time remained significant predictors of surgical site infection on multivariate logistic regression analysis.
Conclusions:
Surgical site infection is an infrequent complication following laparoscopic surgery with the majority occurring at the specimen extraction site. Infection is associated with prolonged operative time and increasing body mass index.
Insights
Surgical site infections (SSIs) are uncommon after laparoscopic urological surgery, with most occurring at specimen extraction sites. Prolonged operative time and higher body mass index are key risk factors for SSIs.
Area of Science:
- Urology
- Minimally Invasive Surgery
- Infectious Disease
Background:
- Surgical site infections (SSIs) are a significant concern in healthcare, classified as
Purpose of the Study:
- To determine the incidence of surgical site infection (SSI) following laparoscopic urological surgery.
- To identify risk factors associated with SSI in this patient population.
Main Methods:
- Retrospective review of 556 patients undergoing transperitoneal laparoscopic urological procedures.
- Analysis of clinical parameters, comorbidities, and operative data using nonparametric testing and logistic regression.
Main Results:
- A 2.5% incidence of SSIs was observed, with most infections (71.4%) at specimen extraction sites.
- Increased operative time and body mass index were significantly associated with SSI development.
- Diabetes mellitus and intraoperative transfusion showed a trend toward significance.
Conclusions:
- Surgical site infection is an infrequent complication of laparoscopic urological surgery.
- Specimen extraction sites are the most common location for SSIs.
- Prolonged operative time and elevated body mass index are significant predictors of SSI.
