Does Transumbilical Incision Influence Surgical Site Infection Rates of the Laparoscopic Sigmoidectomy and Anterior Resection?

Laparoscopic surgery is widespread and is safe and effective for the management of patients with colorectal cancer. However, surgical site infection (SSI) remains an unresolved complication. The present study investigated the comparative effect of supraumbilical incision versus transumbilical incisi...

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Bibliographic Details
Published in:The American surgeon 2015-12, Vol.81 (12), p.1232-1236
Main Authors: Yamamoto, Masashi, Tanaka, Keitaro, Asakuma, Mitsuhiro, Kondo, Keisaku, Isii, Masatsugu, Hamamoto, Hiroki, Okuda, Junji, Uchiyama, Kazuhisa
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Antibiotics
Body mass index
Classification
Colectomy - adverse effects
Colectomy - methods
Colon, Sigmoid - surgery
Colorectal Neoplasms - surgery
Colorectal surgery
Diabetes
Female
Gender
Humans
Incidence
Infections
Japan - epidemiology
Laparoscopy
Laparoscopy - adverse effects
Laparoscopy - methods
Male
Middle Aged
Retrospective Studies
Risk Factors
Skin
Statistical analysis
Studies
Surgical Wound Infection - epidemiology
Surgical Wound Infection - etiology
Umbilicus - surgery
Veins & arteries
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Summary:Laparoscopic surgery is widespread and is safe and effective for the management of patients with colorectal cancer. However, surgical site infection (SSI) remains an unresolved complication. The present study investigated the comparative effect of supraumbilical incision versus transumbilical incision (TU) on the incidence of SSI in patients undergoing laparoscopic surgery for colon cancer. Medical records from patients with colorectal cancer who underwent laparoscopic sigmoid and rectosigmoid colon surgeries with either supraumbilical incision (n = 150) or TU (n = 150) were retrospectively reviewed. There was no difference in demographics, comorbidities, or operative variables between the two groups. The transumbilical group and the supraumbilical group were comparable with regards to overall SSI (6.0% vs 4.0%; P = 0.4062), superficial SSI (6.0% vs 3.3%; P = 0.2704), and deep SSI (0% vs 0.7%; P = 0.2385). SSI developed after laparoscopic sigmoid and rectosigmoid colon cancer surgery in 15 (5.0%) of the 300 patients. Of these superficial SSI, all wounds were in the left lower quadrant incision, and the transumbilical port sites did not become infected. Univariate analysis failed to identify any risk factors for SSI. Avoidance of the umbilicus offers no benefit with regard to SSI compared with TU.
ISSN:0003-1348
1555-9823
DOI:10.1177/000313481508101223