LAPAROSKOPİK VE AÇIK HİSTEREKTOMİLERDE POSTOPERATİF CERRAHİ ALAN ENFEKSİYONLARININ KIYASLANMASI

Yıl 2025, Cilt: 9 Sayı: 3, 128 - 136, 30.12.2025

Sezin Ateş , Haydar Sipahioğlu

https://doi.org/10.33716/bmedj.1691620

https://izlik.org/JA78YB59CM

Öz

Amaç: Histerektomi jinekoloji kliniklerinde en sık yapılan ameliyatlardan birtanesi olup hem laparoskopik hem de açık yöntemle yapılmaktadır.Cerrahi alan enfeksiyonları bu ameliyatın sık ve önemli bir komplikasyonudur.Antibiyotikler histerektomi sonrası gelişen cerrahi alan enfeksiyon riskini azaltan en önemli faktördür.
Gereç ve Yöntemler: Bu çalışma benign patolojiler nedeniyle laparoskopik ve açık histerektomi uygulanan hastalar üzerinde yapıldı.Her iki cerrahi metod postoperatif enfektif komplikasyonlar ve antibiyotik tedavileri yönünden retrospektif olarak incelendi.
Bulgular: Çalışma toplam 111 hasta üzerinde yapıldı.Laparoskopik cerrahi uygulanan hastalarda cerrahi alan enfeksiyonu, ameliyat süresi, rehospitalizasyon ve oral antibiyotik kullanım oranları açık cerrahi uygulanan hastalara göre daha düşük bulundu.Enfektif komplikasyon oranları obez hastalarda, diyabetik hastalarda, cerrahi süresi uzun olan hastalarda ve hastanede yatış süresi uzun olanlarda daha yüksek bulundu. (p<0.05)
Sonuç: Laparoskopik histerektominin; daha düşük cerrahi alan enfeksiyonları,daha kısa hospitalizasyon süresi, daha düşük nazokomiyal enfeksiyon oranları, daha düşük antibiyotik kullanımı ve daha düşük tedavi maliyetleri sağlaması gibi önemli avantajlara sahiptir.

Anahtar Kelimeler

Laparoskopik histerektomi , Açık Histerektomi , Enfeksiyon , Antibiyotik tedavisi , profilaksi

Comparison Of Postoperative Surgical Site Infections in Laparoscopic and Open Hysterectomy

https://izlik.org/JA78YB59CM

Öz

Objectives: Hysterectomy is one of the most frequently performed surgical operations in gynecology clinics and is carried out through either laparoscopic or open surgery. Surgical site infections are among the significant and common complications in this procedure. Antibiotics are one of the most important factors in reducing the risk of surgical site infections after hysterectomy.
Study Design: This study was conducted on patients who underwent laparoscopic and open hysterectomy due to benign pathologies. Both surgical methods were examined in terms of postoperative infectious complications and the antibiotic treatments applied retrospectively.
Results: The study was conducted on a total of 111 patients. Surgical site infection, surgery duration, rehospitalization, and oral antibiotic usage rates were found to be lower in patients who underwent laparoscopic surgery compared to open surgery. Infectious complication rates were detected at a higher rate in obese patients, diabetic patients, and patients with long surgery and hospital stay durations. (p<0.05)
Conclusions: Laparoscopic hysterectomy has significant advantages such as lower surgical site infections, and consequently, shorter hospital stays, lower nosocomial infection rates, reduced antibiotic usage, and lower treatment costs.

Anahtar Kelimeler

Laparoscopic hysterectomy , Open hysterectomy , Prophylaxis. , Antibiotic therapy , İnfection

Etik Beyan

ekte sunulmuştur.

Destekleyen Kurum

yok

Teşekkür

teşekkürler

Kaynakça

• Agarwal, M., Sinha, S., Haripriya, H., Kokkayil, P., & Singh, S.(2023). Surgical Site Infection in Laparoscopic Hysterectomy versus Abdominal Hysterectomy in Gynecological Disease(s): An Overview. Gynecol Minim Invasive Ther, 13(1): 25-29.
• Alkaaki, A., Al Radi, O.O., Khoja, A., Alnawawi, A., Alnawawi, A., Maghrabi, A., Altaf, A., & Aljiffry, M.(2019). Surgical site infection following abdominal surgery:A prospective cohort study. Can J Surg, 62: 111 7.
• Ayeleke, R.O., Mourad, S.M., Marjoribanks, J., Calis, K.A., & Jordan, V.( 2017).Antibiotic prophylaxis for elective hysterectomy. Cochrane Database of Systematic Reviews, 6;CD004637.
• Balcı, O.(2014). Comparison of total laparoscopic hysterectomy and abdominal hysterectomy. Turk J Obstet Gynecol, 11: 224 7.
• Branch-Elliman, W., Ripollone, J., O'Brien, W., Itani, K., Strymish, J., & Gupta, K.(2018). Combination Antimicrobial Prophylaxis for Hysterectomy: Harm without the Benefit? Am J Obstet Gynecol, 218(5): 536-537.
• Bratzler, D.W., Dellinger, E.P., Olsen, K.M., Perl, T.M., Auwaerter, P.G., Bolon, M.K., Fish, D.N., Napolitano, L.M., Sawyer, R.G., Slain, D., Steinberg, J.P., & Weinstein, R.A. (2013). Clinical practice guidelines for antimicrobial prophylaxis in surgery. Surg Infect, 14: 73e156.
• Byun, J.M., & Jeong, D.H. (2020). Antibiotic prophylaxis for gynecologic cancer surgery. Taiwanese Journal of Obstetrics & Gynecology, 59: 514-519.
• Cataife, G., Weinberg, D.A., Wong, H.H., & Kahn, K.L. (2014). The effect of Surgical Care Improvement Project (SCIP) compliance on surgical site infections (SSI). Med Care, 52: S66-73.
• Eyk, N.V., & Schalkwyk, J.V. (2012). Infectious Diseases Comittee, Antibiotic prophylaxis in gynaecologic procedures. J Obstet Gynaecol Can , 34(4): 382-391.
• Fagotti, A., Costantini, B., Fanfani, F., Vizzielli, G., Rossitto, C., Lecca, A., & Giovanni Scambia. (2010). Risk of postoperative pelvic abscess in major gynecologic oncology surgery: one-year single-institution experience. Ann Surg Oncol, 17: 2452–2458.
• Gershensen, C.M., DeCheney, A.H., Curry, S.L., & Brubaker, L. (2001). Postoperative infections. In Operative Gynecology. WB Saunders, 2: 123-31.
• King, J.T., Goulet, J.L., Perkal, M.F., & Rosenthal, R.A..(2011). Glycemic control and infections in patient with diabetes undergoing non cardiac sur-gery. Ann Surg, 253: 158–165.
• Lachiewicz, M.P., Moulton, L.J., & Jaiyeoba, O. (2015). Infection Prevention and Evaluation of Fever After Laparoscopic Hysterectomy. JSLS, 19 (3): e.00065
• Lake, A.G., McPencow, A.M., Dick-Biascoechea, M.A., Martin, D.K., & Erekson, E.A. (2013). Surgical site infection after hysterectomy. Am J Obstet Gynecol, 209(5): 490.e1-490.e9
• Li, M., Han, Y., & Feng, Y.C. (2012). Single-port laparoscopic hysterec-tomy versus conventional laparoscopic hysterectomy: a prospective randomized trial. J Int Med Res, 40: 701–708.
• Mahdi, H., Goodrich, S., Lockhart, D., Debernardo, R., & Kebria, M.M. ( 2014). Predictors of surgicalsite infection in women undergoing hysterectomy for benigngynecologic disease: a multicenter analysis using the National Surgical Quality Improvement Program data. J Minim Invasive Gynecol, 21: 901–909.
• Matthews, K.J., Brock, E., Cohen, S.A., & Chelmow, D.(2014). Hysterectomy in obese patients: special considerations. Clin Obstet Gynecol, 57(1): 106-14.
• Morgan, D.M., Swenson, C.W., Streifel, K.M., Kamdar, N.S., Uppal, S., Burgunder-Zdravkovski, L., Pearlman, M.D., Fenner, D.E., & Campbell, D.A. (2016). Surgical site infection following hysterectomy: adjusted rankings in a regional collaborative. Am J Obstet Gynecol; 214: 259.e1-8.
• Pop-Vicas, A., Musuuza, J.S., Schmitz, M., Al-Niaimi, A., & Safdar, N.(2017). Incidence and risk factors for surgical site infection post-hysterectomy in a tertiary care center. Am J Infect Control, 45(3): 284-287.
• Shockley, M.E., Beran, B., Nutting, H., Arnolds, K., Sprague, M.L., & Zimberg, S. (2017). The Sterility of Selected Operative Sites During Total Laparoscopic Hysterectomy. The Journal of Minimally Invasive Gynecology, 24(6):990-997