Fast-track Surgery Protocol for Hepatectomy and the Rate of Surgical Site Infections: A Single-center Study

• ENAMI Yuta

  Department of Gastrointestinal and General Surgery, Showa University School of Medicine

• AOKI Takeshi

  Department of Gastrointestinal and General Surgery, Showa University School of Medicine

• KUSANO Tomokazu

  Department of Gastrointestinal and General Surgery, Showa University School of Medicine

• NOGAKI Koji

  Department of Gastrointestinal and General Surgery, Showa University School of Medicine

• MATSUDA Kazuhiro

  Department of Gastrointestinal and General Surgery, Showa University School of Medicine

• YAMADA Kosuke

  Department of Gastrointestinal and General Surgery, Showa University School of Medicine

• KOIZUMI Tomotake

  Department of Gastrointestinal and General Surgery, Showa University School of Medicine

• MITAMURA Keitaro

  Department of Gastrointestinal and General Surgery, Showa University School of Medicine

• FUJIMORI Akira

  Department of Gastrointestinal and General Surgery, Showa University School of Medicine

• KOIKE Reiko

  Department of Gastrointestinal and General Surgery, Showa University School of Medicine

• GOTO Satoru

  Department of Gastrointestinal and General Surgery, Showa University School of Medicine

• WATANABE Makoto

  Department of Gastrointestinal and General Surgery, Showa University School of Medicine

• OTSUKA Koji

  Department of Gastrointestinal and General Surgery, Showa University School of Medicine

• MURAKAMI Masahiko

  Department of Gastrointestinal and General Surgery, Showa University School of Medicine

抄録

The fast-track surgery protocol, including perioperative immunonutritional management, is increasingly gaining attention for the prevention of surgical site infections （SSIs）. To analyze the association between the fast-track surgery protocol employed at a single center and outcomes, including SSIs and the length of hospital stays. This retrospective analysis included 217 patients who underwent hepatectomy at the study department between January 2009 and February 2014. Patients were divided into two groups: those managed by a conventional protocol （group C, n＝75） and those managed by the fast-track surgery protocol （group F, n＝142）. There were no significant differences in patient characteristics or factors between the two groups. However, serum albumin and total cholesterol levels before surgery were significantly higher in group F than in group C, and pre-hepatectomy C-reactive protein （CRP） levels were lower in group F than in group C. Moreover, serum albumin and CRP levels at postoperative day 7 were better in group F than in group C. The operations were longer in group F than in group C （312 vs. 286 min） and blood loss volume was less （385 g in group F vs. 428 g in group C）. SSI rates were significantly lower in group F （4.2％, n＝6） than in group C （13.3％, n＝10）, and the length of hospital stay was significantly shorter in group F （16.7 days） than in group C （25.8 days）. The fast-track surgery protocol as a perioperative management strategy may improve preoperative nutritional status and postoperative inflammation, with subsequent reductions in SSI rates and the length of hospital stay in patients undergoing hepatectomy.

収録刊行物

• Ｔｈｅ　Ｓｈｏｗａ　Ｕｎｉｖｅｒｓｉｔｙ　Ｊｏｕｒｎａｌ　ｏｆ　Ｍｅｄｉｃａｌ　Ｓｃｉｅｎｃｅｓ

  Ｔｈｅ　Ｓｈｏｗａ　Ｕｎｉｖｅｒｓｉｔｙ　Ｊｏｕｒｎａｌ　ｏｆ　Ｍｅｄｉｃａｌ　Ｓｃｉｅｎｃｅｓ 32 (2), 147-157, 2020

  昭和大学学士会

キーワード

• fast-track surgery
• hepatectomy
• surgical site infection
• immunonutrition
• albumin

詳細情報

• CRID: 1390285300179481216
• NII論文ID: 130007882459
• DOI: 10.15369/sujms.32.147
• ISSN: 21850968
• ISSN: 09156380
• Web Site: http://id.nii.ac.jp/1670/00003454/
• Web Site: https://www.jstage.jst.go.jp/article/sujms/32/2/32_147/_pdf
• Web Site: https://search.jamas.or.jp/link/ui/2021182200
• 本文言語コード: en
• データソース種別:
  • JaLC
  • IRDB
  • Crossref
  • CiNii Articles
  • KAKEN
• 抄録ライセンスフラグ: 使用不可