title: Surgical site infection impact of pelvic exenteration procedure.
abstract: BACKGROUND
  We sought to investigate morbidity and infectious complications following pelvic exenteration (PEx) and compare infectious complications of patients undergoing PEx and conventional rectal resections.
  
  
  METHODS
  The NSQIP database was utilized to examine the clinical data of patients undergoing elective rectal resections during 2005-2013. Multivariate regression analysis was used to compare postoperative complications of patients who underwent PEx and proctectomy procedure.
  
  
  RESULTS
  We sampled a total of 7,950 patients who underwent rectal resection. Of these, 303 (3.8%) patients underwent pelvic exenteration. Mortality, morbidity, and infectious complications of patients who underwent pelvic exenteration were 1.7%, 65.7%, and 42.6%, respectively. Patients who underwent PEx had a significantly higher rate of morbidity (AOR: 2.01, P < 0.01), overall infectious complications (AOR: 1.49, P < 0.01), hemorrhagic complications (AOR: 3.36, P < 0.01), and surgical site infections (SSI) (AOR: 1.23, P = 0.04) compared to patients who underwent proctectomy. Return to operation room (AOR: 4.99, P < 0.01), obesity (AOR: 1.43, P < 0.01), disseminated cancer (AOR: 1.30, P = 0.01) were significantly associated with SSI complications.
  
  
  CONCLUSIONS
  Postoperative morbidity and infectious complication are significantly higher after PEx procedure. Return to operation room, obesity, and disseminated cancer are strongly associated with surgical site infections complications in rectal surgery. Specific consideration to infectious complications is recommended for these patients.
authors: Department of Surgery, University of California, Irvine, School of Medicine, Irvine, California.
authors: Zhobin
authors: Z
authors: Moghadamyeghaneh
authors: Department of Surgery, University of California, Irvine, School of Medicine, Irvine, California.
authors: Grace S
authors: GS
authors: Hwang
authors: Department of Surgery, University of California, Irvine, School of Medicine, Irvine, California.
authors: Mark H
authors: MH
authors: Hanna
authors: Department of Surgery, University of California, Irvine, School of Medicine, Irvine, California.
authors: Joseph C
authors: JC
authors: Carmichael
authors: Department of Surgery, University of California, Irvine, School of Medicine, Irvine, California.
authors: Steven
authors: S
authors: Mills
authors: Department of Surgery, University of California, Irvine, School of Medicine, Irvine, California.
authors: Alessio
authors: A
authors: Pigazzi
authors: Department of Surgery, University of California, Irvine, School of Medicine, Irvine, California.
authors: Michael J
authors: MJ
authors: Stamos
mesh_terms: D013505:Digestive System Surgical Procedures / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D010385:Pelvic Exenteration / Q000009:adverse effects*; D011183:Postoperative Complications; D011379:Prognosis; D012004:Rectal Neoplasms / Q000473:pathology / Q000601:surgery*; D013530:Surgical Wound Infection / Q000175:diagnosis / Q000209:etiology*
keywords: intra-abdominal infections; rectal cancer; wound infection