title: A comparison of abdominal cavity bacterial contamination of laparoscopy and laparotomy for colorectal cancers.
abstract: OBJECTIVE
  To compare intra-abdominal remnant bacterium between laparotomy and laparoscopic colorectal surgery.
  
  
  METHODS
  72 patients with nonobstructive colorectal cancer were divided into two groups: laparotomy (47 cases) and laparoscopic surgery (25 cases). At the beginning of the operation just after the laparotomy incision was made or the trocars were inserted, 10 ml saline was irrigated into the Douglas pouch and collected through Nelaton's catheter. Just before closing the wound, 10 ml saline was collected in the same way as the initial lavage in both groups. The collected saline as a specimen was determined to obtain the number of surviving bacterium.
  
  
  RESULTS
  No growth of bacteria was observed at the beginning of both operations. The remnant bacterial detection rates from the lavage fluid collected just before closing the wound were 23 of 47 cases (49%) in the laparotomy group and 7 of 25 cases (28%) in the laparoscopic surgery group; higher detection was observed in the laparotomy group. The mean bacteria cell counts after lavage were 4.6 x 10(6) CFU/ml of aerobic bacteria and 1.9 x 10(3) CFU/ml of anaerobic bacteria in the laparotomy group and 1.8 x 10(4) CFU/ml of aerobic bacteria and 1.6 x 10(2) CFU/ml in the laparoscopic surgery group: the laparotomy group demonstrated an apparently higher number of remnant bacterium.
  
  
  CONCLUSIONS
  In colorectal resections, laparoscopic surgery demonstrated a lower incidence of intra-abdominal contamination than laparotomy.
authors.affiliation: Third Department of Surgery, Toho University School of Medicine, Ohashi Medical Center, Tokyo, Japan. yoshisaida@nifty.com
authors.forename: Yoshihisa
authors.initials: Y
authors.lastname: Saida
authors.forename: Jiro
authors.initials: J
authors.lastname: Nagao
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Nakamura
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Nakamura
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Enomoto
authors.forename: Miwa
authors.initials: M
authors.lastname: Katagiri
authors.forename: Shinya
authors.initials: S
authors.lastname: Kusachi
authors.forename: Manabu
authors.initials: M
authors.lastname: Watanabe
authors.forename: Yoshinobu
authors.initials: Y
authors.lastname: Sumiyama
mesh_terms: D000230:Adenocarcinoma / Q000601:surgery*; D000368:Aged; D001420:Bacteria, Aerobic / Q000302:isolation & purification*; D001421:Bacteria, Anaerobic / Q000302:isolation & purification*; D015169:Colony Count, Microbial; D015179:Colorectal Neoplasms / Q000601:surgery*; D005260:Female; D006801:Humans; D010535:Laparoscopy; D007813:Laparotomy; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013997:Time Factors; D016896:Treatment Outcome