title: Impact of intra-operative intraperitoneal chemotherapy on organ/space surgical site infection in patients with gastric cancer.
abstract: BACKGROUND
  Various risk factors for surgical site infection (SSI) have been identified such as age, overweight, duration of surgery, blood loss, etc. Intraperitoneal chemotherapy during surgery is a common procedure in patients with gastric cancer, yet its impact on SSI has not been evaluated.
  
  
  OBJECTIVE
  To evaluate whether intra-operative intraperitoneal chemotherapy is a key risk factor for organ/space SSI in patients with gastric cancer.
  
  
  METHODS
  All patients with gastric cancer who underwent surgery at the Department of Gastrointestinal Surgery between January 2008 and December 2013 were studied. The organ/space SSI rates were compared between patients who received intra-operative intraperitoneal chemotherapy and patients who did not receive intra-operative intraperitoneal chemotherapy, and the risk factors for organ/space SSI were analysed by univariate and multi-variate regression analyses. The microbial causes of organ/space SSI were also identified.
  
  
  RESULTS
  Of the eligible 845 patients, 356 received intra-operative intraperitoneal chemotherapy, and the organ/space SSI rate was higher in these patients compared with patients who did not receive intra-operative intraperitoneal chemotherapy (9.01% vs 3.88%; P = 0.002). Univariate analysis confirmed the significance of this finding (odds ratio 2.443; P = 0.003). As a result, hospital stay was increased in patients who received intra-operative intraperitoneal chemotherapy {mean 20.91 days [95% confidence interval (CI) 19.76-22.06] vs 29.72 days (95% CI 25.46-33.99); P = 0.000}. The results also suggested that intra-operative intraperitoneal chemotherapy may be associated with more Gram-negative bacterial infections.
  
  
  CONCLUSIONS
  Intra-operative intraperitoneal chemotherapy is a significant risk factor for organ/space SSI in patients with gastric cancer.
authors.affiliation: Department of Hospital Infection Management, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, China.
authors.forename: X
authors.initials: X
authors.lastname: Liu
authors.affiliation: Department of Head and Neck Surgery, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, China.
authors.forename: X
authors.initials: X
authors.lastname: Duan
authors.affiliation: Department of Head and Neck Surgery, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, China. Electronic address: xjmcf@sina.com.
authors.forename: J
authors.initials: J
authors.lastname: Xu
authors.affiliation: Department of Gastrointestinal Surgery, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, China.
authors.forename: Q
authors.initials: Q
authors.lastname: Jin
authors.affiliation: Department of Hospital Network Information Centre, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, China.
authors.forename: F
authors.initials: F
authors.lastname: Chen
authors.affiliation: Department of Hospital Infection Management, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, China.
authors.forename: P
authors.initials: P
authors.lastname: Wang
authors.affiliation: Department of Gastrointestinal Surgery, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, China.
authors.forename: Y
authors.initials: Y
authors.lastname: Yang
authors.affiliation: Department of Public Health, Guangxi Medical University, Nanning, China.
authors.forename: X
authors.initials: X
authors.lastname: Tang
mesh_terms: D000328:Adult; D000368:Aged; D004358:Drug Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D007263:Infusions, Parenteral / Q000009:adverse effects* / Q000379:methods; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013274:Stomach Neoplasms / Q000601:surgery*; D013530:Surgical Wound Infection / Q000453:epidemiology* / Q000382:microbiology
keywords: Gastric cancer; Intra-operative intraperitoneal chemotherapy; Organ/space surgical site infection