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Cited by 125Surgical site infection preventionMinimally Invasive Surgical TechniquesAbdominal Surgery and Complications

Infective complications in laparoscopic surgery

Boni, Luigi, Benevento, Angelo, Rovera, Francesca, Dionigi, Gianlorenzo, Giuseppe, Matteo Di, Bertoglio, Camillo, Dionigi, Renzo·2006·Surgical Infections
DOI 10.1089/sur.2006.7.s2-109
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Abstract

BACKGROUND AND PURPOSE: One of the main benefits of minimally invasive surgery compared with open surgery is the significant reduction in the incidence of postoperative infections. Possible explanations include the smaller incision, minimal use of central venous catheters for parenteral nutrition, faster mobilization, reduction in postoperative pain, and better preservation of immune system function with a limited inflammatory response to tissue injury. We compare the incidence of postoperative infections after the most common laparoscopic surgical procedures with that after the corresponding open operation, and review the possible mechanisms behind these results. METHOD: Review of the pertinent literature. RESULTS: Several randomized controlled trials (RCTs), as well as most retrospective studies, show a significant reduction in incisional complications with laparoscopic cholecystectomy in comparison with open surgery (mean 1.1% vs. 4%), as well as in urinary tract and pulmonary infections. In colorectal resection, laparoscopic surgery was characterized by a significant reduction in surgical site infections (mean 5% vs. 9.5%), and the infections that did occur tended to be less severe. Again, there were fewer urinary and pulmonary infections postoperatively. Acute appendicitis represents an interesting setting to study the effect of minimally invasive surgery on infections, as it involves a potentially contaminated field. Most of the results confirm that the rates of surgical site (mean 2% versus 8%) and respiratory (mean 0.3% versus 3%) infections favor laparoscopic surgery, but minimally invasive surgery seems to be characterized by a higher incidence of postoperative intra-abdominal abscess. The laparoscopic approach to splenectomy is clearly superior to standard laparotomy in terms of postoperative complications, including infections, although the rate of overwhelming postsplenectomy infection (OPSI) remains similar because this complication is related more to spleen removal than to the surgical approach. CONCLUSIONS: Most of the literature is in agreement that laparoscopic surgery is associated with better preservation of immune function and a reduction of the inflammatory response compared with open surgery. The rate of postoperative infections seems to be significantly lower.

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  • Prophylactic antibiotics, obesity, and drains have no bearing on the incidence of surgical site infections after laparoscopic cholecystectomy.

    “Prophylactic antibiotics, obesity, and drains have no bearing on the incidence of SSIs after laparoscopic cholecystectomy [33,34].”

    From Insights Into Laparoscopic Port Site Complications: A Comprehensive Review (2024) · cites this paper as [34]

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Authors
Boni, L., Benevento, A., Rovera, F., Dionigi, G., Giuseppe, M. D., Bertoglio, C., & Dionigi, R.
Affiliations
University of Insubria (IT)
ORCID
Venue
Surgical Infections
Publisher
SAGE Publications
Published
2006-07
Volume
7
Issue
supplement 2
Pages
s-109-s-111
ISSN
  • 1096-2964 (ISSN-L)
  • 1557-8674
DOI
10.1089/sur.2006.7.s2-109
OpenAlex
W2000909448
Cited by
125
References
14
Citations by year
2026: 5 · 2025: 2 · 2024: 7 · 2023: 7 · 2022: 4 · 2021: 4 · 2020: 3 · 2019: 6 · 2018: 8 · 2017: 9 · 2016: 6 · 2015: 8 · 2014: 6 · 2013: 2 · 2012: 10
FWCI
8.13
Type
journal article
Language
en
Open access
closed
Licence
www.liebertpub.com/nv/resources-tools/text-and-data-mining-policy/121/ (tdm)
Locations
  • Surgical Infections (publishedVersion)
  • PubMed (publishedVersion)
  • IrInSubria (University of Insubria) (submittedVersion)
Topics
  • Health Sciences › Medicine › Surgery › Surgical site infection prevention
  • Health Sciences › Medicine › Surgery › Minimally Invasive Surgical Techniques
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Abdominal Surgery and Complications
Keywords
laparoscopic surgery, postoperative infection, surgical site infection, laparoscopic cholecystectomy, laparoscopic colorectal resection, laparoscopic appendectomy, laparoscopic splenectomy, intra-abdominal abscess, overwhelming post-splenectomy infection, urinary tract infection, pulmonary infection, minimally invasive surgery, inflammation
MeSH terms
Humans, Infections, Laparoscopy, Postoperative Complications, Surgical Wound Infection

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