[Prognostic factors of postoperative incisional surgical site infections for colorectal cancer]

Zhonghua Wai Ke Za Zhi. 2016 Jun 1;54(6):424-428. doi: 10.3760/cma.j.issn.0529-5815.2016.06.006.
[Article in Chinese]

Abstract

Objective: To explore the prognostic factors of postoperative incisional surgical site infections (I-SSI) for colorectal cancer. Methods: Clinical data of 2 385 colorectal cancer patients undergoing resection by the same surgical team in Department of Colon and Rectum Surgery, Fujian Medical University Union Hospital from January 2000 to February 2014 was analyzed retrospectively. There were 1 421 male and 964 female patients, with a mean age of (59±13) years. Univariate analysis and multivariate Logistic regression analysis were performed for independent prognostic factors of I-SSI. Results: The I-SSI occurred in 77 patients (3.23%). The results of univariate analysis showed that there were statistical differences in body mass index (t=-3.356), operation time (t=-3.609), length of incision (t=-5.492), radical operation (χ2=8.963), laparoscopic surgery (χ2=25.884), combined evisceration (χ2=6.349) and intraoperative blood infusion (χ2=4.176) between two groups (all P<0.05) . The results of multivariate Logistic regression analysis showed that independent prognostic factors of I-SSI were identified to be body mass index (OR=1.087, 95%CI: 1.023 to 1.155, P=0.007), operation time (OR=1.007, 95%CI: 1.002 to 1.012, P=0.006), preoperative chemoradiotherapy (OR=2.434, 95%CI: 1.099 to 5.393, P=0.028) and combined evisceration (OR=2.596, 95%CI: 1.060 to 6.357, P=0.037). The independent protective prognostic factor of I-SSI was identified to be the laparoscopic surgery (OR=0.386, 95%CI: 0.170 to 0.877, P=0.023). Conclusions: Body mass index, operation time, preoperative chemoradiotherapy and combined evisceration are identified to be independent prognostic factors for I-SSI. High-risk patients should receive individualized perioperative intervention. Nevertheless, the laparoscopic surgery can decrease the incidence of I-SSI.

MeSH terms

  • Adult
  • Aged
  • Body Mass Index
  • China / epidemiology
  • Colorectal Neoplasms / complications
  • Colorectal Neoplasms / surgery*
  • Colorectal Surgery*
  • Digestive System Surgical Procedures
  • Female
  • Humans
  • Incidence
  • Laparoscopy*
  • Male
  • Middle Aged
  • Operative Time
  • Postoperative Complications / etiology*
  • Postoperative Period
  • Prognosis
  • Retrospective Studies
  • Risk Factors
  • Surgical Wound Infection / complications*
  • Surgical Wound Infection / epidemiology