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Randomized clinical trial of peritoneal lavage for preventing surgical site infection in elective liver surgery
Author(s) -
Tanaka Kuniya,
Matsuo Kenichi,
Kawaguchi Daisuke,
Murakami Takashi,
Hiroshima Yukihiko,
Hirano Atsushi,
Sato Sho,
Endo Itaru,
Taguri Masataka,
Koda Keiji
Publication year - 2015
Publication title -
journal of hepato‐biliary‐pancreatic sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.63
H-Index - 60
eISSN - 1868-6982
pISSN - 1868-6974
DOI - 10.1002/jhbp.222
Subject(s) - medicine , surgery , confidence interval , therapeutic irrigation , saline , randomized controlled trial
Background Although intraoperative peritoneal lavage is often performed routinely with the aim of reducing peritoneal contamination, little evidence of lavage benefits in elective liver resection without bile duct resection is available. We addressed the issue with a randomized clinical trial. Methods We prospectively and randomly assigned consecutive patients undergoing liver resection to a lavage group or a non‐lavage group. Peritoneal lavage was performed at the end of operation for patients in the lavage group. The primary endpoint was the rate of surgical site infection. Results Ninety‐six patients were assigned to the lavage group and 97 to the non‐lavage group. When superficial/deep incisional infection and organ/space infection were considered together, no significant difference in surgical site infection rate was evident between lavage (21.9%) and non‐lavage groups (13.4%, P = 0.135). However, organ/space infection was significantly more frequent in the lavage group (16.7%) than the non‐lavage group (7.2%, P = 0.048). Peritoneal lavage was identified as a risk factor for organ/space infection by multivariate analysis (relative risk, 2.977; confidence interval, 1.094 to 8.100; P = 0.033). Conclusion Intraoperative peritoneal lavage does not reduce overall incidence of surgical site infection and may increase risk of organ/space infection.