結腸癌に対する腹腔鏡下手術と開腹手術のsurgical site infection発生率の検討

Retrospective examination of the incidence of surgical site infection of laparoscopic versus open surgery for colon cancer

◆要旨：目的●結腸癌に対する腹腔鏡下手術と開腹手術のSSI発生率を検討した．方法●結腸癌511例を腹腔鏡下手術群（Lap群）253例と開腹手術群（Open群）258例に分類し，創感染と腹腔内膿瘍の発生率を検討した．また，手術時間180分を境界に創感染の発生率について検討した．結果●創感染はLap群で5.5％，Open群で14.7％と有意差を認めたが，腹腔内膿瘍に差はなかった．手術時間が180分以内の場合，両群の創感染発生率に有意差がないのに対し，180分を超えるとLap群がOpen群より有意に少なかった．Dukes分類B期とC期に限った検討でも同様の結果だった．結語●腹腔鏡下手術は開腹手術よりSSI発生率は低く，手術時間の影響も少なかった．

　＜Purpose＞We reviewed the incidence of SSI of laparoscopic versus open surgery for colon cancer. ＜Methods＞We classified 511 examples who have colon cancer in laparoscopic-surgery group（Lap group, 253 cases）and open-surgery group（Open group, 258 cases）and reviewed an incidence of wound infection and an intra-peritoneal abscess. In addition, we reviewed an incidence of wound infection in a border in 180 minutes in operation time. ＜Results＞We recognized a significant difference for an incidence of wound infection, but that of intra-peritoneal abscess did not have the difference. In the case of less than 180 minutes operation time, an incidence of wound infection did not have a significant difference between both groups. But it was significantly low incidence in Lap group from Open group when over 180 minutes. Even examination limited for Dukes classification B period and C period was similar results. ＜Conclusion＞Laparoscopic surgery was lower in an SSI incidence than open surgery and there was little influence of operation time.