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Research ArticleClinical Studies

Laparoscopic Liver Resection Procedure Attenuates Organ-space Surgical Site Infection Compared With Open Procedure: A Propensity Score-matched Analysis

KENICHIRO ARAKI, NORIFUMI HARIMOTO, AKIRA WATANABE, MARIKO TSUKAGOSHI, NORIHIRO ISHII, KEI HAGIWARA, RYO MURANUSHI, KOUKI HOSHINO, TAKAOMI SEKI and KEN SHIRABE
Anticancer Research May 2023, 43 (5) 2273-2280; DOI: https://doi.org/10.21873/anticanres.16391
KENICHIRO ARAKI
Division of Hepatobiliary and Pancreatic Surgery, Department of General Surgical Science, Gunma University Graduate School of Medicine, Gunma, Japan
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  • For correspondence: karaki@gunma-u.ac.jp
NORIFUMI HARIMOTO
Division of Hepatobiliary and Pancreatic Surgery, Department of General Surgical Science, Gunma University Graduate School of Medicine, Gunma, Japan
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AKIRA WATANABE
Division of Hepatobiliary and Pancreatic Surgery, Department of General Surgical Science, Gunma University Graduate School of Medicine, Gunma, Japan
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MARIKO TSUKAGOSHI
Division of Hepatobiliary and Pancreatic Surgery, Department of General Surgical Science, Gunma University Graduate School of Medicine, Gunma, Japan
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NORIHIRO ISHII
Division of Hepatobiliary and Pancreatic Surgery, Department of General Surgical Science, Gunma University Graduate School of Medicine, Gunma, Japan
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KEI HAGIWARA
Division of Hepatobiliary and Pancreatic Surgery, Department of General Surgical Science, Gunma University Graduate School of Medicine, Gunma, Japan
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RYO MURANUSHI
Division of Hepatobiliary and Pancreatic Surgery, Department of General Surgical Science, Gunma University Graduate School of Medicine, Gunma, Japan
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KOUKI HOSHINO
Division of Hepatobiliary and Pancreatic Surgery, Department of General Surgical Science, Gunma University Graduate School of Medicine, Gunma, Japan
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TAKAOMI SEKI
Division of Hepatobiliary and Pancreatic Surgery, Department of General Surgical Science, Gunma University Graduate School of Medicine, Gunma, Japan
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KEN SHIRABE
Division of Hepatobiliary and Pancreatic Surgery, Department of General Surgical Science, Gunma University Graduate School of Medicine, Gunma, Japan
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Abstract

Background/Aim: Theoretically, laparoscopic procedures reduce the incidence of surgical site infection (SSI) compared with open surgery. This study aimed to investigate whether laparoscopic liver resection (LLR) attenuates organ-space SSI compared with open liver resection (OLR) using propensity score-matched (PSM) analysis. Patients and Methods: This study included 530 patients who underwent liver resection as the original cohort. PSM was conducted to adjust for confounding factors between OLR and LLR. Two groups were compared regarding the incidence of postoperative complications, including organ-space SSI. We also evaluated risk factors for organ-space SSI using univariate and multivariate analyses. Results: In the original cohort, incidence of bile leakage (p<0.001) and organ-space SSI (p<0.001) were significantly lower in the LLR group than those in the OLR group. A pair of 105 patients were selected for the PSM analysis. After matching, LLR was significantly associated with lower blood loss (p<0.001), longer Pringle clamp time (p<0.001), lower incidence of bile leakage (p=0.035), organ-space SSI (p=0.035), Clavien–Dindo grade ≥III complications (p=0.005), and longer length of hospital stay (p<0.001) than OLR. In multivariate analysis, OLR (p=0.045) was an independent risk factor for organ-space SSI. Conclusion: LLR has potential to reduce the risk of organ-space SSI caused by intra-abdominal abscess and bile leakage more than OLR.

Key Words:
  • Laparoscopic liver resection
  • surgical site infection
  • organ-space
  • postoperative infectious complication
  • Received February 12, 2023.
  • Revision received February 22, 2023.
  • Accepted February 23, 2023.
  • Copyright © 2023 International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.
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Anticancer Research: 43 (5)
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Laparoscopic Liver Resection Procedure Attenuates Organ-space Surgical Site Infection Compared With Open Procedure: A Propensity Score-matched Analysis
KENICHIRO ARAKI, NORIFUMI HARIMOTO, AKIRA WATANABE, MARIKO TSUKAGOSHI, NORIHIRO ISHII, KEI HAGIWARA, RYO MURANUSHI, KOUKI HOSHINO, TAKAOMI SEKI, KEN SHIRABE
Anticancer Research May 2023, 43 (5) 2273-2280; DOI: 10.21873/anticanres.16391

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Laparoscopic Liver Resection Procedure Attenuates Organ-space Surgical Site Infection Compared With Open Procedure: A Propensity Score-matched Analysis
KENICHIRO ARAKI, NORIFUMI HARIMOTO, AKIRA WATANABE, MARIKO TSUKAGOSHI, NORIHIRO ISHII, KEI HAGIWARA, RYO MURANUSHI, KOUKI HOSHINO, TAKAOMI SEKI, KEN SHIRABE
Anticancer Research May 2023, 43 (5) 2273-2280; DOI: 10.21873/anticanres.16391
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Keywords

  • Laparoscopic liver resection
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  • organ-space
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