Ability of minimally invasive surgery to decrease incisional surgical site infection occurrence in patients with colorectal cancer and other gastroenterological malignancies

Abstract

BackgroundSurgical site infection (SSI) is one of the most important complications of surgery for gastroenterological malignancies because it leads to a prolonged postoperative hospital stay and increased inpatient costs. Furthermore, SSI can delay the initiation of postoperative treatments, including adjuvant chemotherapy, negatively affecting patient prognosis. Identifying the risk factors for SSI is important to improving intra- and postoperative wound management for at-risk patients.MethodsPatients with gastroenterological malignancies who underwent surgery at our institution were retrospectively reviewed and categorized according to the presence or absence of incisional SSI. Clinicopathological characteristics such as age, sex, body mass index, malignancy location, postoperative blood examination results, operation time, and blood loss volume were compared between groups. The same analysis was repeated of only patients with colorectal malignancies.ResultsA total of 528 patients (330 men, 198 women; mean age, 68 ± 11 years at surgery) were enrolled. The number of patients with diseases of the esophagus, stomach, small intestine, colon and rectum, liver, gallbladder, and pancreas were 25, 150, seven, 255, 51, five, and 35, respectively. Open surgery was performed in 303 patients vs. laparoscopic surgery in 225 patients. An incisional SSI occurred in 46 patients (8.7%). Multivariate logistic regression analysis showed that postoperative hyperglycemia (serum glucose level ≥140 mg/dl within 24 h after surgery), colorectal malignancy, and open surgery were independent risk factors for incisional SSI. In a subgroup analysis of patients with colorectal malignancy, incisional SSI occurred in 27 (11%) patients. Open surgery was significantly correlated with the occurrence of incisional SSI (P = 0.024).ConclusionsPostoperative hyperglycemia and open surgery were significant risk factors for SSI in patients with gastroenterological malignancies. Minimally invasive surgery could reduce the occurrence of incisional SSI.

A meta‐analysis of the risk factors for surgical site infection in patients with colorectal cancer

“…The sample size was 60–67 613 people. 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 Clean‐contaminated surgical site wounds had a significantly lower infection compared to contaminated surgical site wounds in patients with CCs. Males had significantly higher SSIs compared to females in patients with CCs.…”

“…23 tests that were published between 2001 and 2023 were included in the meta‐analysis after an evaluation of 2309 applicable studies since they fit the inclusion criteria. 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 Table 2 summarizes the findings of these investigations. 89 859 people with CCs were in the used studies' starting point, and 7548 of them had SSIs.…”

Preclinical In-Vivo Safety and Toxicokinetics of D-PLEX100 in an Abdominal Surgery Incision Model in Juvenile Miniature Swine

“… 1 , 2 SSIs can on average extend hospital stays by 9.7 days, resulting in an average of US$25,000 additional cost per case, 1 , 3 – 5 and can delay postoperative treatment and worsen patient outcome. 6 To avoid the unwanted event of SSI, systemic antibiotic prophylaxis is often used. However, this method has limitations in its effectiveness since the local concentration of the given antibiotic at the surgical site may not reach the necessary levels, resulting in ineffective prophylaxis.…”