A comparison of abdominal cavity bacterial contamination of laparoscopy and laparotomy for colorectal cancers.
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.
Saida
Yoshihisa
Y
Third Department of Surgery, Toho University School of Medicine, Ohashi Medical Center, Tokyo, Japan. yoshisaida@nifty.com
Nagao
Jiro
J
Nakamura
Yasushi
Y
Nakamura
Yoichi
Y
Enomoto
Toshiyuki
T
Katagiri
Miwa
M
Kusachi
Shinya
S
Watanabe
Manabu
M
Sumiyama
Yoshinobu
Y
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