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- Title
Multicenter Phase 2 Study about the Safety of No Antimicrobial Prophylaxis Use in Low-Risk Patients Undergoing Laparoscopic Distal Gastrectomy for Gastric Carcinoma (KSWEET-01 Study).
- Authors
Jeong, Oh; Jung, Mi Ran; Ryu, Seong Yeob; Park, Young-Kyu; Kim, Min Chan; Kim, Ki Han; Ryu, Seung Wan; Kwon, In Gyu; Son, Young Gil
- Abstract
Background. Recent studies have shown a lower risk of surgical site infections (SSI) after laparoscopic distal gastrectomy compared to open surgery. This is a phase 2 study aiming to determine the incidence of SSI after laparoscopic distal gastrectomy without using antimicrobial prophylaxis (AMP). Methods. cT1N0 gastric cancers that were subject to laparoscopic distal gastrectomy were enrolled. Based on the unacceptable SSI incidence of ≥12.5% and the target SSI incidence of ≤5%, 105 patients were enrolled with an α of 0.05 and a power of 80% (<ext-link>ClinicalTrials.gov</ext-link>, NCT02200315). Results. In intention-to-treat analysis, patients did not reach the target SSI rate (12.4%, 95% confidence interval=6.8%–19.8%). Of patients, 44 patients had a protocol violation, such as extended lymph node dissection (LND) or inappropriate nonpharmacological SSI prevention measures. Per-protocol analysis excluding these patients (n=61) showed a SSI rate of 4.9%, which was within the target SSI range. Multivariate analysis revealed that extracorporeal anastomosis and extended LND were independent risk factors for SSI. Conclusions. This study failed to reach the target SSI rate without using AMP. However, per-protocol analysis suggests that no AMP might be feasible when limited LND and adequate SSI prevention measures were performed.
- Subjects
SURGICAL site infections; GASTRECTOMY; LAPAROSCOPIC surgery; SURGICAL site; SURGICAL complications; PREVENTIVE medicine; SAFETY standards
- Publication
Gastroenterology Research & Practice, 2017, p1
- ISSN
1687-6121
- Publication type
Article
- DOI
10.1155/2017/8928353