Specific Septic Complications after Rectal Cancer Surgery: A Critical Multicentre Study

Area of Science:

• Gastrointestinal Surgery
• Surgical Oncology
• Colorectal Cancer Management

Background:

• Postoperative septic complications significantly affect patient outcomes and healthcare costs following gastrointestinal surgery.
• Rectal cancer surgery presents specific challenges regarding septic complications, necessitating detailed analysis of contributing factors.

Purpose of the Study:

• To evaluate the causes and impact of septic complications in patients undergoing rectal cancer surgery.
• To identify risk factors associated with abdominal-pelvic septic complications, specifically fistulas.

Main Methods:

• Retrospective analysis of 2674 patients undergoing rectal cancer surgery across three Romanian clinics from 2017-2021.
• Data collection included surgical approach (laparoscopic vs. open), tumor location, preoperative treatment, and complication types.

Main Results:

• 3.67% of patients experienced abdominal-pelvic septic complications (excluding wound infections).
• Preoperative radiochemotherapy significantly increased the risk of suppurations.
• Fistula risk was associated with preoperative treatment, tumor position, and intervention type, but not sex, age, TNM stage, or grade.

Conclusions:

• Preoperative radiochemotherapy is a significant contributing factor to septic complications after rectal cancer surgery.
• Tumor location and surgical approach influence the risk and severity of complications like fistulas.
• While low anterior resection may reduce fistula risk, complications in the lower rectum are more severe.