Assessing the risk factors for surgical site infections after anal reconstruction surgery in patients with anorectal malformations: a retrospective analysis.

IF 1.6 3区 医学 Q2 PEDIATRICS Pediatric Surgery International Pub Date : 2024-12-21 DOI:10.1007/s00383-024-05953-0
Shinichiro Yokoyama, Daisuke Ishii, Soma Sakamura, Insu Kawahara, Satsuki Hashimoto, Yuka Kumata, Takahiro Korai, Kazuyoshi Okumura, Momoko Ara, Takafumi Kondo, Riku Ishimura, Ryo Takahashi, Shoichi Tsuzaka, Masashi Minato, Go Ohba, Hiroshi Yamamoto, Shohei Honda, Hisayuki Miyagi, Akihiro Nui
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Abstract

Purpose: This study aimed to identify surgical site infection (SSI) risk factors after anal reconstruction surgery in patients with anorectal malformations (ARMs).

Methods: This retrospective analysis from January 2013 to December 2022, including all pediatric surgical facilities in Hokkaido, Japan, examined consecutive patients with ARMs, excluding cloacal cases, regarding perioperative and SSI factors during their initial anal reconstruction surgeries.

Results: This study involved 157 cases of major clinical groups and 7 cases of rare/regional variants, among whom 4% developed SSIs. SSIs occurrence varied by type and was primarily observed from the neo-anus to the perineal region. Organ/space SSIs occurred in rectourethral fistula (prostatic/bulbar) and perineal (cutaneous) fistula type. Surgical procedures were abdominal sacroperineal rectoplasty, posterior sagittal anorectoplasty, laparoscopic-assisted anorectal pull-through, cutback anoplasty, and Pott's anoplasty, varied based on the ARM type and facility. In perineal (cutaneous) fistula, vestibular fistula, and anal stenosis cases, a significant association was observed between perianal muscle division and SSIs in patients aged > 4 months (p = 0.04). No significant SSI factors were found in other ARM types.

Conclusion: The choice of procedure as an interventional perioperative factor is suggested to be associated with SSIs. These findings may contribute to making informed decisions regarding surgical procedures in such cases.

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评估肛肠畸形患者肛管重建术后手术部位感染的危险因素:回顾性分析。
目的:本研究旨在探讨肛肠畸形(ARMs)患者肛管重建术后手术部位感染(SSI)的危险因素。方法:回顾性分析2013年1月至2022年12月,包括日本北海道的所有儿科外科机构,对连续的ARMs患者进行初步肛门重建手术的围手术期和SSI因素的分析,不包括肛管病例。结果:本研究涉及157例主要临床组和7例罕见/区域变异,其中4%发生ssi。ssi的发生因类型而异,主要观察从新肛门到会阴区域。器官/空间ssi发生在直肠尿道瘘(前列腺/球)和会阴(皮肤)瘘型。手术方法有腹部骶会阴直肠成形术、后矢状肛门成形术、腹腔镜辅助肛门直肠牵引成形术、切口肛门成形术和Pott肛门成形术,根据ARM类型和设备而有所不同。在会阴(皮肤)瘘、前庭瘘和肛门狭窄病例中,bb0 ~ 4月龄患者的肛周肌分裂与ssi有显著相关性(p = 0.04)。在其他ARM类型中未发现明显的SSI因素。结论:手术方式的选择是围手术期介入治疗的重要因素。这些发现可能有助于在这种情况下做出明智的手术决定。
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来源期刊
CiteScore
3.00
自引率
5.60%
发文量
215
审稿时长
3-6 weeks
期刊介绍: Pediatric Surgery International is a journal devoted to the publication of new and important information from the entire spectrum of pediatric surgery. The major purpose of the journal is to promote postgraduate training and further education in the surgery of infants and children. The contents will include articles in clinical and experimental surgery, as well as related fields. One section of each issue is devoted to a special topic, with invited contributions from recognized authorities. Other sections will include: -Review articles- Original articles- Technical innovations- Letters to the editor
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