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Malignancy is a risk factor for postoperative infectious complications after elective colorectal resection
Thibault Crombe1,2, Jérôme Bot1,2, Mathieu Messager1,2
1Department of Digestive and Oncological Surgery, University Hospital Claude Huriez, Centre Hospitalier Régional Universitaire, Place de Verdun, 59037, Lille cedex, France.
International Journal of Colorectal Disease
|February 4, 2016
Summary
Malignancy significantly increases infectious complications after colorectal surgery. Age, smoking, and obesity also elevate risks, highlighting areas for improved patient management and enhanced recovery protocols.
Area of Science:
- Colorectal surgery
- Surgical oncology
- Infectious disease epidemiology
Background:
- Postoperative infectious complications (ICs) after colorectal surgery are common.
- While patient and technical factors are known, disease-specific factors, particularly malignancy, require further investigation.
- Understanding these factors is crucial for improving patient outcomes.
Purpose of the Study:
- To evaluate the impact of malignancy on postoperative infectious complications (surgical site and extra-surgical site infections) following elective colorectal resection.
- To compare infectious complication rates between patients with benign conditions and those with malignancy.
Main Methods:
- A bicentric retrospective matched-pair study using prospectively gathered data from 1104 patients undergoing elective colorectal resection (2004-2013).
- 305 patients with benign diseases (excluding IBD) were matched to 305 patients with malignancy based on age, gender, ASA score, malnutrition, resection type, and surgical approach.
- Multivariate logistic regression analysis was used to identify risk factors for ICs.
Main Results:
- Patients with malignancy (Group M) exhibited a higher overall IC rate (25.6%) compared to those with benign diseases (Group B) (16.1%) (P=0.004).
- Malignancy was associated with increased risks of extra-surgical site infections (P=0.007) and anastomotic leakage (P=0.039).
- Independent risk factors for ICs included malignancy (OR=2.02), age ≥70 years (OR=1.73), tobacco history (OR=1.87), and obesity (OR=1.68).
Conclusions:
- Malignancy is a significant independent risk factor for infectious complications after colorectal resection.
- Age, tobacco use, and obesity further increase the risk of ICs.
- Strategies should focus on managing modifiable risk factors, enhancing adherence to Enhanced Recovery After Surgery (ERAS) programs, and optimizing immune status in cancer patients.
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