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위절제술 직후 복강 내 세균배양검사 결과와 수술 후 합병증과의 상관관계

The Correlation between the Intraoperative Bacterial Culture for Peritoneal Fluid and Postoperative Complications after Gastrectomy

Journal of Surgical Infection 2020년 5권 2호 p.52 ~ 59
전시열, 권인규, 노성훈, 최승호,
소속 상세정보
전시열 ( Jun Shi-Yeol ) - Yonsei University College of Medicine Gangnam Severance Hospital Department of Surgery
권인규 ( Kwon In-Gyu ) - Yonsei University College of Medicine Gangnam Severance Hospital Department of Surgery
노성훈 ( Noh Sung-Hoon ) - Yonsei University College of Medicine Gangnam Severance Hospital Department of Surgery
최승호 ( Choi Seung-Ho ) - Yonsei University College of Medicine Gangnam Severance Hospital Department of Surgery

Abstract


Objectives: Gastrectomy is a clean-contaminated surgery. The purpose of this study is to analyze correlation between bacterial contamination of intraperitoneal fluid immediately after surgery and postoperative complications.

Methods: The medical records of 266 patients who were diagnosed with gastric cancer and underwent gastrectomy from June 15, 2015 to March 20, 2020 at Gangnam Severance Hospital were retrospectively analyzed. Peritoneal fluid via drain catheter was collected in operation room and send to laboratory for bacterial culture.

Results: There were 2 patients with 4 types of bacteria cultured, 11 patients with 3 types, 76 patients with 2 types, 170 patients with 1 type of bacteria. There were 7 patients with no bacterial growth. When the bacteria were classified as pathogenicity, there was no correlation with postoperative complication rate. There was no correlation between the genus of bacteria and complications. However, when Streptococcus pneumonia was identified, complications increased significantly (odds ratio [95% confidence interval]=25.55 [1.228-530.222], p=0.0364). As a result of multivariate analysis, body mass index and operation time were factors that influence complications statistically. Additionally, in complications of Grade III or higher, the growth of S.pneumonia, operation time, and combined organ resection were significantly correlated with postoperative complications.

Conclusion: When a bacterial culture test was performed with intraperitoneal fluid immediately after gastrectomy, bacteria grew up in 97.4%. However, there was no correlation between the culture of bacteria and complications. S.pneumonia was correlated with overall complications, serious complications, and infectious complications. Therefore, active monitoring should be considered for patients with S.pneumonia growth.

키워드

Gastrectomy; Ascitic fluid; Bacteria; Postoperative complications

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