Minimally Invasive Surgery Reduces Risk of Hospital-Acquired Infections

Laparoscopic surgery reduces the risk of nosocomial infections by half when compared to open surgery, according to a new study.

Researchers at California Pacific Medical Center (CPMC, San Francisco, USA) conducted a retrospective study of more than 11,000 patients that had undergone laparoscopic or open hysterectomy (43.3% of patients), gallbladder removal (32.7%), and appendectomy (24%), between September 1, 2004 and December 31, 2006, at 22 hospitals across the United States. The study utilized the Nosocomial Infection Marker (NIM) to measure infection (in a previous multi-hospital study, the NIM algorithm identified nosocomial infections with 86% sensitivity and 98.5% specificity).

The results showed that 337 patients (2.89%) experienced at least one nosocomial infection. Overall, infection rates were nearly twice as high for open procedures (4.09%) than for laparoscopic procedures (2.11%). Laparoscopic surgery was associated with reduction of the risk of nosocomial infections during gallbladder removal by 66% and during hysterectomy by 52%, compared to open surgery. The study showed the reduction rates of nosocomial infections during laparoscopic appendectomy were not statistically significant. The study also discovered that 40% of the infections identified occurred within 30 days after hospital discharge. The study was published in the April 2008 edition of Surgical Endoscopy.

"This study gives more definitive evidence that laparoscopic surgery reduces the risk of nosocomial infection compared to open surgery, which may lead to improved patient care and potential reductions in costs to the healthcare system, " said lead author Andrew Brill, M.D., director of minimally invasive gynecology at CPMC.

Study results also showed that laparoscopic surgery was associated with a reduction in the overall odds ratio for each type of nosocomial infection. Compared to open surgery, patients in the study who underwent laparoscopic surgery experienced 80% reduction in the odds of respiratory tract infection, 69% reduction in bloodstream infection, 59% reduction in wound infection, 39% reduction in urinary tract infection, and a 48% reduction in other types of nosocomial infections across hysterectomies, cholecystectomies, and appendectomies.


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