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Risks and outcomes of surgical site infection after minimally invasive colorectal surgery: a Japanese multicenter

Toshio Shiraishi1,2, Shintaro Hashimoto1, Tetsuro Tominaga1

  • 1Division of Surgical Oncology, Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852- 8501, Japan.

Surgery Today
|May 27, 2026
PubMed
Abstract

Insights

Minimally invasive surgery for colorectal cancer can lead to surgical site infections (SSI). Blood loss and preoperative treatment are key risk factors for SSI, impacting patient prognosis.

Area of Science:

  • Oncology
  • Surgical Innovation
  • Infectious Disease

Background:

  • Surgical site infections (SSI) are a concern following minimally invasive surgery (MIS) for colorectal cancer.
  • Limited data exists on the specific risk factors and prognostic implications of SSI in this patient population.

Purpose of the Study:

  • To evaluate the occurrence, risk factors, and prognostic impact of SSI after MIS for colorectal cancer.
  • To identify predictors of different types of SSI (incisional/deep vs. organ/space).

Main Methods:

  • A multicenter retrospective study involving 3276 patients undergoing curative MIS for colorectal cancer (2016-2024).
  • Patients were categorized into incisional/deep SSI, organ/space SSI, and no-SSI groups.
  • Logistic regression and Cox proportional hazards analyses were used to assess risk factors and prognosis.

Main Results:

  • In colon cancer, increased blood loss independently predicted both incisional/deep SSI and organ/space SSI.
  • Preoperative treatment was an independent predictor for both types of SSI in rectal cancer.
  • Organ/space SSI in pathological node-negative colon cancer patients was associated with significantly worse 5-year relapse-free survival and overall survival.

Conclusions:

  • Preoperative treatment and blood loss are significant risk factors for SSI after colorectal MIS.
  • Appropriate adjuvant chemotherapy administration is crucial for improving prognosis in patients who develop SSI.
Keywords:
Colorectal cancerMinimally invasive surgerySurgical site infection

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