Surgical site infection after laparoscopic resection of colorectal cancer is associated with compromised long-term oncological outcome.
Colorectal cancer
Laparoscopic surgery
Postoperative infection
Surgical site infection
Journal
World journal of surgical oncology
ISSN: 1477-7819
Titre abrégé: World J Surg Oncol
Pays: England
ID NLM: 101170544
Informations de publication
Date de publication:
07 Apr 2022
07 Apr 2022
Historique:
received:
09
01
2022
accepted:
18
03
2022
entrez:
7
4
2022
pubmed:
8
4
2022
medline:
9
4
2022
Statut:
epublish
Résumé
We evaluated the influence of infectious complications, particularly surgical site infection (SSI), on long-term oncological results after elective laparoscopic resection of colorectal cancer. A total of 199 patients who underwent laparoscopic elective resection with negative resection margins for stage I-III colorectal cancer were retrospectively examined. The postoperative course was recorded based on hospital records, and cancer relapse was diagnosed based on radiological or pathological findings under a standardized follow-up program. The severity of complications was graded using Clavien-Dindo (CD) classification. SSI was found in 25 patients (12.6%), with 12 (6.0%) showing anastomotic leak. The postoperative relapse-free survival (RFS) rate was significantly lower in patients with SSI (49.2%) than in patients without SSI (87.2%, P<0.001). Differences in RFS were found after both colectomy and rectal resection (P<0.001 and P<0.001, respectively). RFS did not differ between patients who had major SSI CD (grade III) and those who had minor SSI CD (grades I or II). Multivariate Cox regression analysis identified the occurrence of SSI and pathological stage as independent co-factors for RFS (P<0.001 and P=0.003). These results suggest that postoperative SSI compromises long-term oncological results after laparoscopic colorectal resection. Further improvements in surgical technique and refinements in perioperative care may improve long-term oncological results.
Sections du résumé
BACKGROUND
BACKGROUND
We evaluated the influence of infectious complications, particularly surgical site infection (SSI), on long-term oncological results after elective laparoscopic resection of colorectal cancer.
METHODS
METHODS
A total of 199 patients who underwent laparoscopic elective resection with negative resection margins for stage I-III colorectal cancer were retrospectively examined. The postoperative course was recorded based on hospital records, and cancer relapse was diagnosed based on radiological or pathological findings under a standardized follow-up program. The severity of complications was graded using Clavien-Dindo (CD) classification.
RESULTS
RESULTS
SSI was found in 25 patients (12.6%), with 12 (6.0%) showing anastomotic leak. The postoperative relapse-free survival (RFS) rate was significantly lower in patients with SSI (49.2%) than in patients without SSI (87.2%, P<0.001). Differences in RFS were found after both colectomy and rectal resection (P<0.001 and P<0.001, respectively). RFS did not differ between patients who had major SSI CD (grade III) and those who had minor SSI CD (grades I or II). Multivariate Cox regression analysis identified the occurrence of SSI and pathological stage as independent co-factors for RFS (P<0.001 and P=0.003).
CONCLUSION
CONCLUSIONS
These results suggest that postoperative SSI compromises long-term oncological results after laparoscopic colorectal resection. Further improvements in surgical technique and refinements in perioperative care may improve long-term oncological results.
Identifiants
pubmed: 35387666
doi: 10.1186/s12957-022-02578-2
pii: 10.1186/s12957-022-02578-2
pmc: PMC8988355
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
111Informations de copyright
© 2022. The Author(s).
Références
Int J Colorectal Dis. 2011 Apr;26(4):415-21
pubmed: 21174107
Int J Surg. 2018 Apr;52:303-308
pubmed: 29530829
Br J Cancer. 2011 Feb 15;104(4):726-34
pubmed: 21266974
Cancer Cell. 2009 Feb 3;15(2):103-13
pubmed: 19185845
Dis Colon Rectum. 2013 Jan;56(1):20-8
pubmed: 23222276
Ann Coloproctol. 2020 Aug;36(4):273-280
pubmed: 32054256
J Gastrointest Surg. 2018 Aug;22(8):1418-1433
pubmed: 29589264
Lancet Gastroenterol Hepatol. 2017 Apr;2(4):261-268
pubmed: 28404155
Surg Today. 2017 Jun;47(6):743-754
pubmed: 27783149
Ann Surg. 2014 Jul;260(1):23-30
pubmed: 24509190
BMJ. 2015 Jan 02;350:g7607
pubmed: 25555821
J Biol Chem. 2003 Jun 13;278(24):21631-8
pubmed: 12690099
Gastroenterology. 2015 Sep;149(3):614-22
pubmed: 26026393
Clin Colorectal Cancer. 2017 Dec;16(4):264-274
pubmed: 28412137
BMC Cancer. 2019 Aug 23;19(1):833
pubmed: 31443699
Ann Surg. 2017 Mar;265(3):539-546
pubmed: 27070934
Dis Colon Rectum. 2016 Mar;59(3):236-44
pubmed: 26855399
Chin J Cancer. 2017 Dec 21;36(1):96
pubmed: 29268783
Br J Cancer. 2009 Mar 10;100(5):701-6
pubmed: 19209171
JAMA Surg. 2015 Sep;150(9):890-8
pubmed: 26132363
Ann Surg. 2011 May;253(5):890-9
pubmed: 21394013
J Clin Oncol. 2008 Jan 10;26(2):303-12
pubmed: 18182672
Int J Surg. 2015 Oct;22:3-9
pubmed: 26283295
BMC Cancer. 2017 Nov 10;17(1):744
pubmed: 29126400
Int J Colorectal Dis. 2019 Feb;34(2):319-328
pubmed: 30470941
Ann Surg Oncol. 2009 Feb;16(2):311-8
pubmed: 19037699
J Am Coll Surg. 2010 Aug;211(2):232-8
pubmed: 20670861
Int J Colorectal Dis. 2016 Nov;31(11):1775-1784
pubmed: 27604812
Ann Surg. 2014 May;259(5):930-8
pubmed: 24045445
Ann Surg. 2012 Dec;256(6):1034-8
pubmed: 22584695
Surgery. 2017 Aug;162(2):317-324
pubmed: 28433249
Ann Surg. 2004 Aug;240(2):205-13
pubmed: 15273542
Int J Colorectal Dis. 2020 Mar;35(3):413-422
pubmed: 31897647
Surg Today. 1998;28(6):576-9
pubmed: 9681604
Nature. 2002 Dec 19-26;420(6917):860-7
pubmed: 12490959
Ann Surg. 2006 Nov;244(5):758-63
pubmed: 17060769
Gastroenterology. 2010 Jun;138(6):2101-2114.e5
pubmed: 20420949
Dis Colon Rectum. 2019 Mar;62(3):286-293
pubmed: 30540662
J Anus Rectum Colon. 2019 Oct 30;3(4):175-195
pubmed: 31768468
Br J Cancer. 2007 Nov 5;97(9):1211-7
pubmed: 17968426
Br J Cancer. 2010 Sep 7;103(6):870-6
pubmed: 20717110
Int J Colorectal Dis. 2019 Feb;34(2):277-283
pubmed: 30426197
Oncol Lett. 2010 Jan;1(1):119-125
pubmed: 22966268
Colorectal Dis. 2015 Feb;17(2):141-9
pubmed: 25156234
Am J Surg. 2011 Sep;202(3):259-64
pubmed: 21871980
Ann Surg. 2011 Jul;254(1):83-9
pubmed: 21572320
Medicine (Baltimore). 2016 Apr;95(14):e3271
pubmed: 27057884
Ann Surg Oncol. 2018 Jan;25(1):188-196
pubmed: 29116488
Am J Infect Control. 1999 Apr;27(2):97-132; quiz 133-4; discussion 96
pubmed: 10196487
Ann Surg Oncol. 2013 May;20(5):1575-83
pubmed: 23076557
World J Gastroenterol. 2017 Sep 14;23(34):6212-6219
pubmed: 28974887