title: Impact of operation timing on post-operative infections following colorectal cancer surgery.
abstract: BACKGROUND
  To investigate the impact of operation timing on post-operative infections in a cohort of patients undergoing colorectal cancer surgery.
  
  
  METHODS
  We prospectively analysed surgical outcomes in patients who underwent colorectal cancer surgery at the First Affiliated Hospital, College of Medicine, Zhejiang University, from January to December in 2014. In this non-randomized trial, patients were divided into three groups according to the surgery start time: CT1 (07:00 to 12:00 h), CT2 (12:01 to 18:00 h), and CT3 (18:01 h to midnight). The primary outcome was the proportion of patients developing infections within 4 weeks of the surgical procedure.
  
  
  RESULTS
  Out of 756 patients that were enrolled in the study, 118 developed post-operative infections. The results from blood and pus culture showed 97.1% specimen as being pathogen-free. The overall incidence of post-operative infection was 14.5% (38 of 262), 15.3% (46 of 300) and 17.5% (34 of 194) in the CT1, CT2 and CT3 group, respectively, with no significant inter-group differences. However, white blood cell counts, C-reactive protein and glucose levels at 24 h after the surgical procedure showed significant differences between the three groups (one-way ANOVA, P < 0.05).
  
  
  CONCLUSIONS
  The occurrence of post-operative infection in patients undergoing colorectal cancer surgery was not associated with operation timing. The expression of several inflammatory markers, such as white blood cell counts, C-reactive protein and blood glucose levels tended to correlate with the surgery start time.
authors.affiliation: Department of Anesthesiology, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.
authors.forename: Cai-Xia
authors.initials: CX
authors.lastname: Li
authors.affiliation: Department of Anesthesiology, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.
authors.forename: Xiao-Xia
authors.initials: XX
authors.lastname: An
authors.affiliation: Department of Anesthesiology, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.
authors.forename: Bing
authors.initials: B
authors.lastname: Zhao
authors.affiliation: Department of Anesthesiology, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.
authors.forename: Shui-Jing
authors.initials: SJ
authors.lastname: Wu
authors.affiliation: Department of Anesthesiology, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.
authors.forename: Guo-Hao
authors.initials: GH
authors.lastname: Xie
authors.affiliation: Department of Anesthesiology, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.
authors.forename: Xiang-Ming
authors.initials: XM
authors.lastname: Fang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose / Q000378:metabolism; D002097:C-Reactive Protein / Q000378:metabolism; D002681:China / Q000453:epidemiology; D015331:Cohort Studies; D015179:Colorectal Neoplasms / Q000097:blood / Q000601:surgery*; D005260:Female; D006801:Humans; D015994:Incidence; D018655:Lymphocyte Count; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D011446:Prospective Studies; D013530:Surgical Wound Infection / Q000097:blood / Q000453:epidemiology / Q000209:etiology*; D055815:Young Adult
chemical_list: D001786:Blood Glucose; D002097:C-Reactive Protein
keywords: colorectal cancer surgery; inflammatory marker; operation timing; post-operative infection