Surgical site infection in laparoscopic colon surgery: a cohort study

Colon surgery is among the procedures with the highest rates of surgical site infection (SSI). The aim of this study was to assess the incidence of SSI in laparoscopic colon surgery and to identify potential associated risk factors.

A prospective cohort study was conducted from July 2012 to July 2024. Patients undergoing laparoscopic colon surgery at Hospital Universitario Fundación Alcorcón were consecutively included. The incidence of SSI in laparoscopic surgery was evaluated, along with its potential association with preoperative preparation, adequacy of antibiotic prophylaxis, and other risk factors related to surgical wound infection. Explanatory binary logistic regression models with backward stepwise selection were fitted. Potential interactions between the risk factors identified in laparoscopic procedures and type of surgical approach (laparoscopic vs. non-laparoscopic) were also assessed.

The study included 491 patients who underwent laparoscopic surgery and 1,209 who underwent non-laparoscopic surgery. The incidence of SSI was 6.1% (95% CI: 4.3-8.6) in laparoscopic procedures and 14.6% (95% CI: 12.8-16.7) in non-laparoscopic procedures. Inadequate preoperative preparation was associated with the occurrence of SSI (OR: 4.3; 95% CI: 1.85-10.1; p-value: 0.001), independently of patient age and NHNS index. This association between preoperative preparation and SSI was not observed in non-laparoscopic surgeries.

A high level of compliance with preoperative preparation may provide an additional benefit in laparoscopic colon surgery compared with open surgery.