胃癌術後の手術部位感染対策と効果

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  • MEASURES TO PREVENT SURGICAL SITE INFECTION AFTER GASTRECTOMY AND THEIR EFFECTS

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To reduce the complications after gastrectomy, especially SSI (surgical site infection), we analyzed risk factors of SSI and intervened in the management of gastrectomy. In the first place, we analyzed 76 consecutive patients undergoing gastrectomy for gastric cancer from April 2003 to October 2003 about risk factors of SSI. There were significant differences in age, drain type (closed type or open type), the term up to removing a drain, and the term up to starting meal as risk factors of SSI. In the second place, based on the results, we intervened in the management of 65 consecutive patients from November 2003 to April 2004. We improved the management of gastrectomy in the followings; 1) using the closed type drain, 2) avoiding aimless prolongation of the time for placing a drain (by certifying anastomotic leakage and pancreatic fistula by fluoroscopic examination and measuring amylase in the drain fluid on the fourth day after operation at the latest), and 3) hastening the time to meal intake at 71th day to 5th day after operation. In consequence, the rate of SSI was drastically reduced from 27.6% in the first term to 4.6% in the latter term. The decline in SSI resulted in a shortered hospital stay after surgery and a saving of medical cost.

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