Imperial College London
Portrait Picture

Dr James Kinross

Faculty of Medicine, Department of Surgery & Cancer

Reader in General Surgery
 
 
 
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Contact

 

+44 (0)20 3312 1947j.kinross

 
 
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Location

 

1029Queen Elizabeth the Queen Mother Wing (QEQM)St Mary's Campus

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Summary

 

Publications

Citation

BibTex format

@article{Mason:2016:10.1007/s00464-016-5195-0,
author = {Mason, SE and Kinross, JM and Hendricks, J and Arulampalam, TH},
doi = {10.1007/s00464-016-5195-0},
journal = {Surgical Endoscopy},
pages = {1923--1929},
title = {Postoperative hypothermia and surgical site infection following peritoneal insufflation with warm, humidified carbon dioxide during laparoscopic colorectal surgery: a cohort study with cost-effectiveness analysis.},
url = {http://dx.doi.org/10.1007/s00464-016-5195-0},
volume = {31},
year = {2016}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - BACKGROUND: Surgical Site Infection (SSI) occurs in 9 % of laparoscopic colorectal surgery. Warming and humidifying carbon dioxide (CO2) used for peritoneal insufflation may protect against SSI by avoiding postoperative hypothermia (itself a risk factor for SSI). This study aimed to assess the impact of CO2 conditioning on postoperative hypothermia and SSI and to perform a cost-effectiveness analysis. METHODS: A retrospective cohort study of patients undergoing elective laparoscopic colorectal resection was performed at a single UK specialist centre. The control group (n = 123) received peritoneal insufflation with room temperature, dry CO2, whereas the intervention group (n = 123) received warm, humidified CO2 (using HumiGard™, Fisher & Paykel Healthcare). The outcomes were postoperative hypothermia, SSI and costs. Multivariate analysis was performed. RESULTS: A total of 246 patients were included in the study. The mean age was 68 (20-87) and mean BMI 28 (15-51). The primary diagnosis was cancer (n = 173), and there were no baseline differences between the groups. CO2 conditioning significantly decreased the incidence of postoperative hypothermia (odds ratio 0.10, 95 % CI 0.04-0.23), with hypothermic patients found to be at increased risk of SSI (odds ratio 4.0, 95 % CI 1.25-12.9). Use of conditioned CO2 significantly decreased the incidence of SSI by 66 % (p = 0.04). The intervention group incurred costs of £155 less per patient. The incremental cost-effectiveness ratio was negative. CONCLUSION: CO2 conditioning during laparoscopic colorectal surgery is a safe, feasible and a cost-effective intervention. It improves the quality of surgical care relating to SSI and postoperative hypothermia.
AU  - Mason,SE
AU  - Kinross,JM
AU  - Hendricks,J
AU  - Arulampalam,TH
DO  - 10.1007/s00464-016-5195-0
EP  - 1929
PY  - 2016///
SN  - 0930-2794
SP  - 1923
TI  - Postoperative hypothermia and surgical site infection following peritoneal insufflation with warm, humidified carbon dioxide during laparoscopic colorectal surgery: a cohort study with cost-effectiveness analysis.
T2  - Surgical Endoscopy
UR  - http://dx.doi.org/10.1007/s00464-016-5195-0
UR  - http://www.ncbi.nlm.nih.gov/pubmed/27734204
UR  - http://hdl.handle.net/10044/1/47959
VL  - 31
ER  -
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