Bacteriological examination of stomach mucosa and periodontal pocket in patients with gastric cancer: A study protocol

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Purpose: The preventive effect of oral management on postoperative infectious complications (POICs) is still unclear in gastrointestinal surgery. We previously reported in a retrospective study that periodontal disease (PD) is an independent risk factor for POICs. To elucidate the bacterial relationship between the oral cavity and stomach, we evaluated the preoperative oral environment and examined bacterial culture tests in both periodontal pockets and the stomach mucosa in patients undergoing radical resection for gastric cancer.

Methods: This was a single-arm prospective cohort study. Patients scheduled to undergo gastrectomy for gastric adenocarcinoma were enrolled. Before surgery, the dentists assessed the severity of PD by measuring the periodontal pocket probing depth, collected specimens from periodontal pockets, and submitted those specimens for a bacterial culture examination. Surgeons cut out a piece of the stomach mucosa (20 × 20 mm) from the resected stomach immediately after surgery. We then evaluated the kinds of bacterial strain and the association between the severity of PD and the positive rate of stomach bacterial culture. When patients had POICs, we identified the pathogen.