Atsushi Ikeda1,2, Yosuke Fukunaga1, Takashi Akiyoshi1, Satoshi Nagayama1, Toshiya Nagasaki1, Tomohiro Yamaguchi1, Toshiki Mukai1, Yukiharu Hiyoshi1, Tsuyoshi Konishi3,4. 1. Department of Gastroenterological Surgery, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan. 2. Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan. 3. Department of Gastroenterological Surgery, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan. tkonishi-tky@umin.ac.jp. 4. Department of Surgical Oncology, The University of Texas, M.D. Anderson Cancer Center, 1400 Pressler Street Unit 1484, Houston, TX, 77030, USA. tkonishi-tky@umin.ac.jp.
Abstract
OBJECTIVES: This prospective observational study aimed to clarify the incidence and independent risk factors of wound infection after laparoscopic surgery for primary colonic and rectal cancer. METHODS: A prospective surveillance of surgical site infection (SSI) was conducted in consecutive patients with primary colorectal cancer, who underwent elective laparoscopic surgery in a single comprehensive cancer center between 2005 and 2014. The outcomes of interest were the incidence and risk factors of wound infection. RESULTS: In total, 3170 patients were enrolled in the study. The overall incidence of wound infection was 3.0%. The incidence of wound infection was significantly higher in rectal surgery than in colonic surgery (4.7 vs. 2.1%, p < 0.001). In rectal surgery, independent risk factors for developing wound infection included abdominoperineal resection (p < 0.001, odds ratio [OR] = 11.4, 95% confidence interval [CI]: 5.04-24.8), body mass index (BMI) ≥ 25 kg/m2 (p = 0.041, OR = 1.97, 95% CI, 1.03-3.76), and chemoradiotherapy (p = 0.032, OR = 2.18, 95% CI, 1.07-4.45). In laparoscopic colonic surgery, no significant risk factors were identified. CONCLUSIONS: Laparoscopic rectal surgery has a higher risk of wound infection than colonic surgery. Laparoscopic rectal surgery involving abdominoperineal resection, patients with higher BMI, and chemoradiotherapy requires careful observation in wound care and countermeasures against wound infection.
OBJECTIVES: This prospective observational study aimed to clarify the incidence and independent risk factors of wound infection after laparoscopic surgery for primary colonic and rectal cancer. METHODS: A prospective surveillance of surgical site infection (SSI) was conducted in consecutive patients with primary colorectal cancer, who underwent elective laparoscopic surgery in a single comprehensive cancer center between 2005 and 2014. The outcomes of interest were the incidence and risk factors of wound infection. RESULTS: In total, 3170 patients were enrolled in the study. The overall incidence of wound infection was 3.0%. The incidence of wound infection was significantly higher in rectal surgery than in colonic surgery (4.7 vs. 2.1%, p < 0.001). In rectal surgery, independent risk factors for developing wound infection included abdominoperineal resection (p < 0.001, odds ratio [OR] = 11.4, 95% confidence interval [CI]: 5.04-24.8), body mass index (BMI) ≥ 25 kg/m2 (p = 0.041, OR = 1.97, 95% CI, 1.03-3.76), and chemoradiotherapy (p = 0.032, OR = 2.18, 95% CI, 1.07-4.45). In laparoscopic colonic surgery, no significant risk factors were identified. CONCLUSIONS: Laparoscopic rectal surgery has a higher risk of wound infection than colonic surgery. Laparoscopic rectal surgery involving abdominoperineal resection, patients with higher BMI, and chemoradiotherapy requires careful observation in wound care and countermeasures against wound infection.
Authors: Jensen T Poon; Wai-Lun Law; Ivan W Wong; Patricia T Ching; Lisa M Wong; Joe K M Fan; Oswens S H Lo Journal: Ann Surg Date: 2009-01 Impact factor: 12.969
Authors: Antonio Sciuto; Giovanni Merola; Giovanni D De Palma; Maurizio Sodo; Felice Pirozzi; Umberto M Bracale; Umberto Bracale Journal: World J Gastroenterol Date: 2018-06-07 Impact factor: 5.742