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開催概要
開催回
第56回・2018年・横浜
 

胃癌手術における口腔内細菌と術後感染性合併症の関連

演題番号 : P9-8

[筆頭演者]
演者)西川 真央:1 
[共同演者]
本多 通孝:1、木村 亮介:1、小林 綾花:1、山口 裕二:1、池谷 進:1、堀 創史:1、小林 拓史:1、河村 英恭:1、中山 祐次郎:1、外舘 幸敏:1、高野 祥直:1、瀬戸 晥一:1

1:総合南東北病院

 

Background; The perioperative oral care has been promising intervention to prevent infectious complications after surgery for patients with esophageal or head and neck cancer. We previously showed that the severe periodontal disease was a risk factor of infectious complications in gastrointestinal surgery, although the pathophysiological evidence was still unclear. In this study, we focus on gastric cancer patients and investigate the relationship between the risk of postoperative complications and bacteria in the periodontal pockets and stomach.
Patients and Methods; Consecutive patients who underwent radical gastrectomy for gastric adenocarcinoma from January 2016 to March 2018 were enrolled. We evaluated patients' clinical data and oral environment; periodontal disease, tooth stump, tongue fur, dry mouth and oral hygiene index. The primary outcome was postoperative infectious complications. As an exploratory study, we also evaluated the bacteriological findings in 27 cases; we performed bacterial culture from specimens of oral plaques in the periodontal pocket and gastric mucosa.
Results; Total of 222 patients were enrolled. The median age was 69 including 144 male and 78 female. The incident of infectious complications were 1/18(5.6%), 17/119(14.3%) and 12/60(20.0%) in mild, intermediate and severe periodontal disease, respectively. There were not significant correlation between other oral findings and outcoms. In the logistic regression analysis, the periodontal pocket depth, surgical approach and smoking were identified. The bacteriological findings in gastric mucosa showed positive of bacteria culture were 0/4(0%), 4/13(30.8%) and 6/10(60.0%) in mild, intermediate and severe periodontal disease, respectively (p=0.089).
Conclusion; Severe periodontal disease is the risk of postoperative infectious complications. In further study, we will investigate more detail on the bacteriological association.

キーワード

臓器別:胃・十二指腸

手法別:集学的治療

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