Risk factors for surgical-site infections after radical gastrectomy for gastric cancer: a study in China

Abstract

Background About 10% of patients get a surgical-site infection (SSI) after radical gastrectomy for gastric cancer, but SSI remains controversial among surgeons. The aim of this study was to explore the risk factors for SSIs after radical gastrectomy in patients with gastric cancer to guide clinical therapies and reduce the incidence of SSI. Methods The study was a retrospective cohort study in patients who underwent radical gastrectomy for gastric cancer. SSI was defined in accordance with the National Nosocomial Infection Surveillance System. We evaluated patient-related and peri-operative variables that could be risk factors for SSIs. The Chi-squared test and logistic regression analysis were used to assess the association between these risk factors and SSI. Results Among the 590 patients, 386 were men and 204 were women. The mean age was 56.6 (28–82) years and 14.2% (84/590) of these patients had an SSI. Among them, incisional SSI was observed in 23 patients (3.9%) and organ/space SSI in 61 patients (10.3%). Multivariate logistic regression analysis identified sex (odds ratios [ORs] = 2.548, and 95% confidence interval [CI]: 1.268–5.122, P = 0.009), total gastrectomy (OR = 2.327, 95% CI: 1.352–4.004, P = 0.002), albumin level (day 3 after surgery) <30 g/L (OR = 1.868, 95% CI: 1.066–3.274, P = 0.029), and post-operative total parenteral nutrition (OR = 2.318, 95% CI: 1.026–5.237, P = 0.043) as independent risk factors for SSI. Conclusions SSI was common among patients after radical gastrectomy for gastric cancer. The method supporting post-operative nutrition and the duration of prophylactic antibiotics may be important modifiable influencing factors for SSI.

Predictors for different types of surgical site infection in patients with gastric cancer: A systematic review and meta‐analysis

“…Our results revealed a significant 1.33‐fold increase in SSI risk among male gastric cancer patients, consistent with previous studies 18–22 . This elevated risk may be attributed to gender‐related differences in skin colonization 19 and the influence of sex hormones on the immune system, with oestrogen boosting immune function and testosterone suppressing it 11 .…”

Surgical Site Infections in patients undergoing major oncological surgery during the COVID‐19 paNdemic (SCION): A propensity‐matched analysis

“…About 37% of our patients had surgery that extended >4 h (38% in Cohort A and 36% in Cohort B). Our overall incidence of SSI of 20% and 15.9% in Cohorts A and B, respectively, is within the accepted norms for patients undergoing major cancer surgery 12–20 …”

“…SSI rates for patients undergoing oncologic surgeries have a wide range reported between 1.4% and 38%, depending upon the type of surgical wounds, prior treatment received, various comorbidities, and the site involved 12–20 . Our cohort constituted a population of patients undergoing major elective surgery for various primary cancers with the largest sites being breast, head and neck, and GI malignancies.…”

Bcl-2-associated transcription factor 1 Ser290 phosphorylation mediates DNA damage response and regulates radiosensitivity in gastric cancer

“…GC patients are often diagnosed after the disease has progressed to the advanced stage where the long term outlook is very poor and the 5-year survival rate is only 10%-20% [ 4 ]. Current treatment strategies for GC include surgical resection, chemotherapy and radiation therapy, however the effects are limited [ 5 , 6 ]. In recent years, the development of molecular targeted therapy has led to a revolutionary breakthrough and become the hope of cancer treatment.…”