Skip to main content
Erschienen in: International Journal of Colorectal Disease 2/2019

13.11.2018 | Original Article

Oncological outcome of surgical site infection after colorectal cancer surgery

verfasst von: Jung Wook Huh, Woo Yong Lee, Yoon Ah Park, Yong Beom Cho, Hee Cheol Kim, Seong Hyeon Yun, Ho-Kyung Chun

Erschienen in: International Journal of Colorectal Disease | Ausgabe 2/2019

Einloggen, um Zugang zu erhalten

Abstract

Background

This study evaluated the oncological outcome of surgical site infection (SSI) after colorectal cancer surgery.

Methods

A total of 3675 consecutive patients with colorectal cancer who underwent curative resection from January 2009 to December 2011 were analyzed. The prognostic significance of SSI was evaluated. Risk factors for SSI were also identified using multivariate regression analysis.

Results

Overall SSI rate was 9.6%, in which 5.5% was superficial or deep SSI and 4.1% was organ/space SSI. Incidence of SSI varied significantly with tumor location (P < 0.001): 7.1% in colon cancer and 14.0% in rectal cancer. With a median follow-up period of 49.8 months, the 5-year disease-free survival rates of patients without and with SSI were 87% and 83%, respectively (P = 0.018). SSI predicted disease-free survival in univariate analysis. However, SSI was not an independent predictor of survival in multivariate analysis. Body mass index, ASA score, preoperative WBC count, rectal tumor, open surgery, operation time, and transfusion during surgery were independent predictors of SSI.

Conclusion

SSI predicted disease-free survival in colorectal cancer patients following curative surgery. Patient’ demographics, tumor characteristics, and perioperative conditions were independently associated with an increased likelihood of SSI.
Literatur
1.
Zurück zum Zitat Hedrick TL, Sawyer RG, Friel CM, Stukenborg GJ (2013) A method for estimating the risk of surgical site infection in patients with abdominal colorectal procedures. Dis Colon Rectum 56:627–637CrossRefPubMed Hedrick TL, Sawyer RG, Friel CM, Stukenborg GJ (2013) A method for estimating the risk of surgical site infection in patients with abdominal colorectal procedures. Dis Colon Rectum 56:627–637CrossRefPubMed
2.
Zurück zum Zitat Krieger BR, Davis DM, Sanchez JE, Mateka JJ, Nfonsam VN, Frattini JC, Marcet JE (2011) The use of silver nylon in preventing surgical site infections following colon and rectal surgery. Dis Colon Rectum 54:1014–1019CrossRefPubMed Krieger BR, Davis DM, Sanchez JE, Mateka JJ, Nfonsam VN, Frattini JC, Marcet JE (2011) The use of silver nylon in preventing surgical site infections following colon and rectal surgery. Dis Colon Rectum 54:1014–1019CrossRefPubMed
3.
Zurück zum Zitat Anthony T, Murray BW, Sum-Ping JT, Lenkovsky F, Vornik VD, Parker BJ, McFarlin JE, Hartless K, Huerta S (2011) Evaluating an evidence-based bundle for preventing surgical site infection: a randomized trial. Arch Surg 146:263–269CrossRefPubMed Anthony T, Murray BW, Sum-Ping JT, Lenkovsky F, Vornik VD, Parker BJ, McFarlin JE, Hartless K, Huerta S (2011) Evaluating an evidence-based bundle for preventing surgical site infection: a randomized trial. Arch Surg 146:263–269CrossRefPubMed
4.
Zurück zum Zitat Ju MH, Ko CY, Hall BL, Bosk CL, Bilimoria KY, Wick EC (2015) A comparison of 2 surgical site infection monitoring systems. JAMA Surg 150:51–57CrossRefPubMed Ju MH, Ko CY, Hall BL, Bosk CL, Bilimoria KY, Wick EC (2015) A comparison of 2 surgical site infection monitoring systems. JAMA Surg 150:51–57CrossRefPubMed
5.
Zurück zum Zitat Murray AC, Pasam R, Estrada D, Kiran RP (2016) Risk of surgical site infection varies based on location of disease and segment of colorectal resection for Cancer. Dis Colon Rectum 59:493–500CrossRefPubMed Murray AC, Pasam R, Estrada D, Kiran RP (2016) Risk of surgical site infection varies based on location of disease and segment of colorectal resection for Cancer. Dis Colon Rectum 59:493–500CrossRefPubMed
6.
Zurück zum Zitat Sutton E, Miyagaki H, Bellini G, Shantha Kumara HM, Yan X, Howe B, Feigel A, Whelan RL (2017) Risk factors for superficial surgical site infection after elective rectal cancer resection: a multivariate analysis of 8880 patients from the American College of Surgeons National Surgical Quality Improvement Program database. J Surg Res 207:205–214CrossRefPubMed Sutton E, Miyagaki H, Bellini G, Shantha Kumara HM, Yan X, Howe B, Feigel A, Whelan RL (2017) Risk factors for superficial surgical site infection after elective rectal cancer resection: a multivariate analysis of 8880 patients from the American College of Surgeons National Surgical Quality Improvement Program database. J Surg Res 207:205–214CrossRefPubMed
7.
Zurück zum Zitat Amri R, Dinaux AM, Kunitake H, Bordeianou LG, Berger DL (2017) Risk stratification for surgical site infections in Colon Cancer. JAMA Surg 152:686–690CrossRefPubMedPubMedCentral Amri R, Dinaux AM, Kunitake H, Bordeianou LG, Berger DL (2017) Risk stratification for surgical site infections in Colon Cancer. JAMA Surg 152:686–690CrossRefPubMedPubMedCentral
8.
Zurück zum Zitat Kirkland KB, Briggs JP, Trivette SL, Wilkinson WE, Sexton DJ (1999) The impact of surgical-site infections in the 1990s: attributable mortality, excess length of hospitalization, and extra costs. Infect Control Hosp Epidemiol 20:725–730CrossRefPubMed Kirkland KB, Briggs JP, Trivette SL, Wilkinson WE, Sexton DJ (1999) The impact of surgical-site infections in the 1990s: attributable mortality, excess length of hospitalization, and extra costs. Infect Control Hosp Epidemiol 20:725–730CrossRefPubMed
9.
Zurück zum Zitat Olsen MA, Chu-Ongsakul S, Brandt KE, Dietz JR, Mayfield J, Fraser VJ (2008) Hospital-associated costs due to surgical site infection after breast surgery. Arch Surg 143:53–60 discussion 61CrossRefPubMed Olsen MA, Chu-Ongsakul S, Brandt KE, Dietz JR, Mayfield J, Fraser VJ (2008) Hospital-associated costs due to surgical site infection after breast surgery. Arch Surg 143:53–60 discussion 61CrossRefPubMed
10.
Zurück zum Zitat Murthy BL, Thomson CS, Dodwell D, Shenoy H, Mikeljevic JS, Forman D, Horgan K (2007) Postoperative wound complications and systemic recurrence in breast cancer. Br J Cancer 97:1211–1217CrossRefPubMedPubMedCentral Murthy BL, Thomson CS, Dodwell D, Shenoy H, Mikeljevic JS, Forman D, Horgan K (2007) Postoperative wound complications and systemic recurrence in breast cancer. Br J Cancer 97:1211–1217CrossRefPubMedPubMedCentral
11.
Zurück zum Zitat Grandis JR, Snyderman CH, Johnson JT, Yu VL, D'Amico F (1992) Postoperative wound infection. A poor prognostic sign for patients with head and neck cancer. Cancer 70:2166–2170CrossRefPubMed Grandis JR, Snyderman CH, Johnson JT, Yu VL, D'Amico F (1992) Postoperative wound infection. A poor prognostic sign for patients with head and neck cancer. Cancer 70:2166–2170CrossRefPubMed
12.
Zurück zum Zitat Tsujimoto H, Ichikura T, Ono S, Sugasawa H, Hiraki S, Sakamoto N, Yaguchi Y, Yoshida K, Matsumoto Y, Hase K (2009) Impact of postoperative infection on long-term survival after potentially curative resection for gastric cancer. Ann Surg Oncol 16:311–318CrossRefPubMed Tsujimoto H, Ichikura T, Ono S, Sugasawa H, Hiraki S, Sakamoto N, Yaguchi Y, Yoshida K, Matsumoto Y, Hase K (2009) Impact of postoperative infection on long-term survival after potentially curative resection for gastric cancer. Ann Surg Oncol 16:311–318CrossRefPubMed
13.
Zurück zum Zitat Nespoli A, Gianotti L, Bovo G, Brivio F, Nespoli L, Totis M (2006) Impact of postoperative infections on survival in colon cancer patients. Surg Infect 7(Suppl 2):S41–S43CrossRef Nespoli A, Gianotti L, Bovo G, Brivio F, Nespoli L, Totis M (2006) Impact of postoperative infections on survival in colon cancer patients. Surg Infect 7(Suppl 2):S41–S43CrossRef
14.
Zurück zum Zitat Mangram AJ, Horan TC, Pearson ML, Silver LC, Jarvis WR (1999) Guideline for prevention of surgical site infection, 1999. Centers for Disease Control and Prevention (CDC) hospital infection control practices advisory committee. Am J Infect Control 27:97–132 quiz 133–134; discussion 196CrossRef Mangram AJ, Horan TC, Pearson ML, Silver LC, Jarvis WR (1999) Guideline for prevention of surgical site infection, 1999. Centers for Disease Control and Prevention (CDC) hospital infection control practices advisory committee. Am J Infect Control 27:97–132 quiz 133–134; discussion 196CrossRef
15.
Zurück zum Zitat Mrak K, Eberl T, Laske A, Jagoditsch M, Fritz J, Tschmelitsch J (2013) Impact of postoperative complications on long-term survival after resection for rectal cancer. Dis Colon Rectum 56:20–28CrossRefPubMed Mrak K, Eberl T, Laske A, Jagoditsch M, Fritz J, Tschmelitsch J (2013) Impact of postoperative complications on long-term survival after resection for rectal cancer. Dis Colon Rectum 56:20–28CrossRefPubMed
16.
Zurück zum Zitat Matthiessen P, Hallbook O, Andersson M, Rutegard J, Sjodahl R (2004) Risk factors for anastomotic leakage after anterior resection of the rectum. Color Dis 6:462–469CrossRef Matthiessen P, Hallbook O, Andersson M, Rutegard J, Sjodahl R (2004) Risk factors for anastomotic leakage after anterior resection of the rectum. Color Dis 6:462–469CrossRef
17.
Zurück zum Zitat Krarup PM, Nordholm-Carstensen A, Jorgensen LN, Harling H (2014) Anastomotic leak increases distant recurrence and long-term mortality after curative resection for colonic cancer: a nationwide cohort study. Ann Surg 259:930–938CrossRefPubMed Krarup PM, Nordholm-Carstensen A, Jorgensen LN, Harling H (2014) Anastomotic leak increases distant recurrence and long-term mortality after curative resection for colonic cancer: a nationwide cohort study. Ann Surg 259:930–938CrossRefPubMed
18.
Zurück zum Zitat Mirnezami A, Mirnezami R, Chandrakumaran K, Sasapu K, Sagar P, Finan P (2011) Increased local recurrence and reduced survival from colorectal cancer following anastomotic leak: systematic review and meta-analysis. Ann Surg 253:890–899CrossRefPubMed Mirnezami A, Mirnezami R, Chandrakumaran K, Sasapu K, Sagar P, Finan P (2011) Increased local recurrence and reduced survival from colorectal cancer following anastomotic leak: systematic review and meta-analysis. Ann Surg 253:890–899CrossRefPubMed
19.
Zurück zum Zitat Park JS, Huh JW, Park YA, Cho YB, Yun SH, Kim HC, Lee WY (2016) Risk factors of anastomotic leakage and long-term survival after colorectal surgery. Medicine (Baltimore) 95:e2890CrossRef Park JS, Huh JW, Park YA, Cho YB, Yun SH, Kim HC, Lee WY (2016) Risk factors of anastomotic leakage and long-term survival after colorectal surgery. Medicine (Baltimore) 95:e2890CrossRef
20.
Zurück zum Zitat Lawson EH, Hall BL, Ko CY (2013) Risk factors for superficial vs deep/organ-space surgical site infections: implications for quality improvement initiatives. JAMA Surg 148:849–858CrossRefPubMed Lawson EH, Hall BL, Ko CY (2013) Risk factors for superficial vs deep/organ-space surgical site infections: implications for quality improvement initiatives. JAMA Surg 148:849–858CrossRefPubMed
21.
Zurück zum Zitat Pendlimari R, Cima RR, Wolff BG, Pemberton JH, Huebner M (2012) Diagnoses influence surgical site infections (SSI) in colorectal surgery: a must consideration for SSI reporting programs? J Am Coll Surg 214:574–580 discussion 580-571CrossRefPubMed Pendlimari R, Cima RR, Wolff BG, Pemberton JH, Huebner M (2012) Diagnoses influence surgical site infections (SSI) in colorectal surgery: a must consideration for SSI reporting programs? J Am Coll Surg 214:574–580 discussion 580-571CrossRefPubMed
22.
Zurück zum Zitat Tang R, Chen HH, Wang YL, Changchien CR, Chen JS, Hsu KC, Chiang JM, Wang JY (2001) Risk factors for surgical site infection after elective resection of the colon and rectum: a single-center prospective study of 2,809 consecutive patients. Ann Surg 234:181–189CrossRefPubMedPubMedCentral Tang R, Chen HH, Wang YL, Changchien CR, Chen JS, Hsu KC, Chiang JM, Wang JY (2001) Risk factors for surgical site infection after elective resection of the colon and rectum: a single-center prospective study of 2,809 consecutive patients. Ann Surg 234:181–189CrossRefPubMedPubMedCentral
23.
Zurück zum Zitat Young H, Knepper B, Moore EE, Johnson JL, Mehler P, Price CS (2012) Surgical site infection after colon surgery: National Healthcare Safety Network risk factors and modeled rates compared with published risk factors and rates. J Am Coll Surg 214:852–859CrossRefPubMed Young H, Knepper B, Moore EE, Johnson JL, Mehler P, Price CS (2012) Surgical site infection after colon surgery: National Healthcare Safety Network risk factors and modeled rates compared with published risk factors and rates. J Am Coll Surg 214:852–859CrossRefPubMed
24.
Zurück zum Zitat Schietroma M, Cecilia EM, Sista F, Carlei F, Pessia B, Amicucci G (2014) High-concentration supplemental perioperative oxygen and surgical site infection following elective colorectal surgery for rectal cancer: a prospective, randomized, double-blind, controlled, single-site trial. Am J Surg 208:719–726CrossRefPubMed Schietroma M, Cecilia EM, Sista F, Carlei F, Pessia B, Amicucci G (2014) High-concentration supplemental perioperative oxygen and surgical site infection following elective colorectal surgery for rectal cancer: a prospective, randomized, double-blind, controlled, single-site trial. Am J Surg 208:719–726CrossRefPubMed
25.
Zurück zum Zitat Anaya DA, Cormier JN, Xing Y, Koller P, Gaido L, Hadfield D, Chemaly RF, Feig BW (2012) Development and validation of a novel stratification tool for identifying cancer patients at increased risk of surgical site infection. Ann Surg 255:134–139CrossRefPubMed Anaya DA, Cormier JN, Xing Y, Koller P, Gaido L, Hadfield D, Chemaly RF, Feig BW (2012) Development and validation of a novel stratification tool for identifying cancer patients at increased risk of surgical site infection. Ann Surg 255:134–139CrossRefPubMed
26.
Zurück zum Zitat Ejaz A, Schmidt C, Johnston FM, Frank SM, Pawlik TM (2017) Risk factors and prediction model for inpatient surgical site infection after major abdominal surgery. J Surg Res 217:153–159CrossRefPubMed Ejaz A, Schmidt C, Johnston FM, Frank SM, Pawlik TM (2017) Risk factors and prediction model for inpatient surgical site infection after major abdominal surgery. J Surg Res 217:153–159CrossRefPubMed
27.
Zurück zum Zitat Mavros MN, Xu L, Maqsood H, Gani F, Ejaz A, Spolverato G, Al-Refaie WB, Frank SM, Pawlik TM (2015) Perioperative blood transfusion and the prognosis of pancreatic Cancer surgery: systematic review and meta-analysis. Ann Surg Oncol 22:4382–4391CrossRefPubMed Mavros MN, Xu L, Maqsood H, Gani F, Ejaz A, Spolverato G, Al-Refaie WB, Frank SM, Pawlik TM (2015) Perioperative blood transfusion and the prognosis of pancreatic Cancer surgery: systematic review and meta-analysis. Ann Surg Oncol 22:4382–4391CrossRefPubMed
28.
Zurück zum Zitat Vamvakas EC, Blajchman MA (2009) Transfusion-related mortality: the ongoing risks of allogeneic blood transfusion and the available strategies for their prevention. Blood 113:3406–3417CrossRefPubMed Vamvakas EC, Blajchman MA (2009) Transfusion-related mortality: the ongoing risks of allogeneic blood transfusion and the available strategies for their prevention. Blood 113:3406–3417CrossRefPubMed
29.
Zurück zum Zitat Hajjar LA, Vincent JL, Galas FR, Nakamura RE, Silva CM, Santos MH, Fukushima J, Kalil Filho R, Sierra DB, Lopes NH, Mauad T, Roquim AC, Sundin MR, Leao WC, Almeida JP, Pomerantzeff PM, Dallan LO, Jatene FB, Stolf NA, Auler JO Jr (2010) Transfusion requirements after cardiac surgery: the TRACS randomized controlled trial. JAMA 304:1559–1567CrossRefPubMed Hajjar LA, Vincent JL, Galas FR, Nakamura RE, Silva CM, Santos MH, Fukushima J, Kalil Filho R, Sierra DB, Lopes NH, Mauad T, Roquim AC, Sundin MR, Leao WC, Almeida JP, Pomerantzeff PM, Dallan LO, Jatene FB, Stolf NA, Auler JO Jr (2010) Transfusion requirements after cardiac surgery: the TRACS randomized controlled trial. JAMA 304:1559–1567CrossRefPubMed
30.
Zurück zum Zitat Howard DP, Datta G, Cunnick G, Gatzen C, Huang A (2010) Surgical site infection rate is lower in laparoscopic than open colorectal surgery. Color Dis 12:423–427CrossRef Howard DP, Datta G, Cunnick G, Gatzen C, Huang A (2010) Surgical site infection rate is lower in laparoscopic than open colorectal surgery. Color Dis 12:423–427CrossRef
31.
Zurück zum Zitat Kiran RP, El-Gazzaz GH, Vogel JD, Remzi FH (2010) Laparoscopic approach significantly reduces surgical site infections after colorectal surgery: data from national surgical quality improvement program. J Am Coll Surg 211:232–238CrossRefPubMed Kiran RP, El-Gazzaz GH, Vogel JD, Remzi FH (2010) Laparoscopic approach significantly reduces surgical site infections after colorectal surgery: data from national surgical quality improvement program. J Am Coll Surg 211:232–238CrossRefPubMed
Metadaten
Titel
Oncological outcome of surgical site infection after colorectal cancer surgery
verfasst von
Jung Wook Huh
Woo Yong Lee
Yoon Ah Park
Yong Beom Cho
Hee Cheol Kim
Seong Hyeon Yun
Ho-Kyung Chun
Publikationsdatum
13.11.2018
Verlag
Springer Berlin Heidelberg
Erschienen in
International Journal of Colorectal Disease / Ausgabe 2/2019
Print ISSN: 0179-1958
Elektronische ISSN: 1432-1262
DOI
https://doi.org/10.1007/s00384-018-3194-4

Weitere Artikel der Ausgabe 2/2019

International Journal of Colorectal Disease 2/2019 Zur Ausgabe

Vorsicht, erhöhte Blutungsgefahr nach PCI!

10.05.2024 Koronare Herzerkrankung Nachrichten

Nach PCI besteht ein erhöhtes Blutungsrisiko, wenn die Behandelten eine verminderte linksventrikuläre Ejektionsfraktion aufweisen. Das Risiko ist umso höher, je stärker die Pumpfunktion eingeschränkt ist.

Darf man die Behandlung eines Neonazis ablehnen?

08.05.2024 Gesellschaft Nachrichten

In einer Leseranfrage in der Zeitschrift Journal of the American Academy of Dermatology möchte ein anonymer Dermatologe bzw. eine anonyme Dermatologin wissen, ob er oder sie einen Patienten behandeln muss, der eine rassistische Tätowierung trägt.

Deutlich weniger Infektionen: Wundprotektoren schützen!

08.05.2024 Postoperative Wundinfektion Nachrichten

Der Einsatz von Wundprotektoren bei offenen Eingriffen am unteren Gastrointestinaltrakt schützt vor Infektionen im Op.-Gebiet – und dient darüber hinaus der besseren Sicht. Das bestätigt mit großer Robustheit eine randomisierte Studie im Fachblatt JAMA Surgery.

Chirurginnen und Chirurgen sind stark suizidgefährdet

07.05.2024 Suizid Nachrichten

Der belastende Arbeitsalltag wirkt sich negativ auf die psychische Gesundheit der Angehörigen ärztlicher Berufsgruppen aus. Chirurginnen und Chirurgen bilden da keine Ausnahme, im Gegenteil.

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

Karpaltunnelsyndrom BDC Leitlinien Webinare
CME: 2 Punkte

Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis
Berufsverband der Deutschen Chirurgie e.V.

S2e-Leitlinie „Distale Radiusfraktur“

Radiusfraktur BDC Leitlinien Webinare
CME: 2 Punkte

Das Webinar beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske
Dr. med. Benjamin Meyknecht
Berufsverband der Deutschen Chirurgie e.V.

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

Appendizitis BDC Leitlinien Webinare
CME: 2 Punkte

Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric
Berufsverband der Deutschen Chirurgie e.V.