Risk Factors for Perioperative Infection in Laparoscopic Fundoplication for Neurologically Impaired Patients

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  • 重症心身障がい児（者）における腹腔鏡下噴門形成術周術期の感染症リスクファクターの検討
  • ジュウショウ シンシンショウ ガ イ ジ(モノ)ニ オケル フククウキョウ カ フンモン ケイセイジュツシュウジュツキ ノ カンセンショウ リスクファクター ノ ケントウ

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Abstract

Purpose: Laparoscopic fundoplication for neurologically impaired patients (NIPs) occasionally results in complication caused by severe infection during the perioperative period. The purpose of this study was to investigate the risk factors for perioperative infection after surgery in NIPs for safe perioperative management.<br> Methods: Fifty-three NIPs who underwent laparoscopic fundoplication in our department between June 2006 and December 2011 were retrospectively evaluated. The primary diseases of NIPs were severe neonatal asphyxia, chromosomal abnormality, and refractory epilepsy among others. We examined the risk factors for perioperative infection in NIPs who underwent laparoscopic fundoplication, such as bacterial factors, patient factors, and surgical management factors.<br> Results: Thirteen patients developed perioperative infection. Univariate analysis was carried out on the above-mentioned risk factors, and no significant difference was observed. However, infection with low-virulence bacilli, operation during infancy, low height-to-weight ratio, and absence of tracheal diversion were suggested as risk factors. Multivariate analysis showed that infection with low-virulence bacilli (p = 0.02) and absence of tracheostomy or laryngotracheal separation (p = 0.04) were significant risk factors.<br> Conclusion: In laparoscopic fundoplication in NIPs, infection with low-virulence bacilli and absence of tracheostomy or laryngotracheal separation were risk factors for perioperative infection. We should perform adequate management of NIPs with these risk factors.

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