[Analysis of risk factors of intra-abdominal infection after surgery for colorectal cancer].
OBJECTIVE
To investigate the risk factors of intra-abdominal infection(IAI) after colorectal cancer surgery.


METHODS
Clinical and follow-up data of 773 colorectal cancer patients undergoing operation in our hospital from October 2011 to December 2014 were retrospectively analyzed. Patients were divided into intra-abdominal cavity infection group (110 cases, IAI group) and non intra-abdominal infection group(663 cases, non-IAI group). All the patients administered prophylactic antibiotics 30 minutes to 2 hours before operation. Univariate and multivariate analysis were performed to evaluate the risk factors of IAI.


RESULTS
Preoperative factors associated with postoperative IAI included hepatic cirrhosis, kidney diseases, diabetes or other basic diseases, prophylactic use of drugs, hypoalbuminemia, anemia, intestinal obstruction, and American Society of Anesthesiologists (ASA) anesthetic grading score (all P<0.05). Postoperative factors associated with postoperative IAI included use of laparoscopy or stapler, united exenteration, existence of anastomotic fistula, time of drainage tube placement, operation time and tumor staging (all P<0.05). Multivariate logistic regression analysis showed that preoperative diabetes(OR=2.36, 95% CI:1.45 to 4.76, P<0.01), combined exenteration (OR=2.02, 95% CI:1.02 to 4.00, P<0.01), anastomotic leak (OR=4.41, 95% CI:1.77 to 10.99, P=0.001), operation time≥140 minutes (OR=2.88, 95% CI:1.78 to 4.67, P<0.01) and period of postoperative drainage≥10 days(OR=4.57, 95% CI:2.78 to 7.52, P<0.01) were independent risk factors of postoperative IAI, while the use of stapler was protective factor (OR=0.37, 95% CI: 0.23 to 0.60, P<0.01). Compared with prophylactic use of cephamycins plus metronidazole, cefuroxime plus metronidazole had a higher rate of IAI(OR=2.10, 95% CI:1.23 to 3.58, P=0.007).


CONCLUSIONS
Prevention of postoperative IAI is required for colorectal cancer patients, particularly in those with preoperative diabetes, combined exenteration, anastomotic leak, operation time longer than 140 minutes and postoperative drainage period longer than 10 days. Preoperative use of cephamycins plus metronidazole has better efficacy in prevention of postoperative IAI.
Department of nosocomial infection, The First Hospital of Jiaxing, Zhejiang Jiaxing 314000, China. jialei1839@163.com.
Lei
L
Jia
Department of nosocomial infection, The First Hospital of Jiaxing, Zhejiang Jiaxing 314000, China.
Jinqi
J
Lu
Department of nosocomial infection, The First Hospital of Jiaxing, Zhejiang Jiaxing 314000, China.
Xiefeng
X
Ma
Department of Surgical Oncology, The First Hospital of Jiaxing, Zhejiang Jiaxing 314000, China.
Honggang
H
Jiang
Department of Surgical Oncology, The First Hospital of Jiaxing, Zhejiang Jiaxing 314000, China.
Yi
Y
Zhu
Department of nosocomial infection, The First Hospital of Jiaxing, Zhejiang Jiaxing 314000, China.
Yuting
Y
Liu
Department of nosocomial infection, The First Hospital of Jiaxing, Zhejiang Jiaxing 314000, China.
Ying
Y
Cai
Department of nosocomial infection, The First Hospital of Jiaxing, Zhejiang Jiaxing 314000, China.
Yuqi
Y
Zhang
D057868:Anastomotic Leak; D015179:Colorectal Neoplasms / Q000601:surgery*; D013505:Digestive System Surgical Procedures / Q000009:adverse effects*; D004322:Drainage; D006801:Humans; D007415:Intestinal Obstruction; D059413:Intraabdominal Infections / Q000453:epidemiology*; D010535:Laparoscopy; D009367:Neoplasm Staging; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D012307:Risk Factors