title: Clinical and surgical factors associated with organ/space surgical site infection after laparoscopic gastrectomy for gastric cancer.
abstract: Surgical site infection (SSI), particularly organ/space SSI, remains a clinically important issue even after laparoscopic gastrectomy (LG) for gastric cancer (GC). This study aimed to identify specific clinical and surgical factors associated with organ/space SSI after LG.
  
  
  
  This was a retrospective study of 407 patients who underwent LG for clinical stage I GC. SSI was defined according to the National Nosocomial Infection Surveillance System. The incidence and treatment outcomes of either incisional or organ/space SSI after LG were examined, and the risk factors for each type of SSI were identified using univariate and multivariate analyses.
  
  
  
  Organ/space SSI was observed in 21 patients (5.2 %), while incisional SSI was detected in 18 patients (4.4 %). Although no mortality was observed, the occurrence of either incisional or organ/space SSI significantly prolonged postoperative hospital stays (p = 0.000 and 0.000, respectively); however, organ/space SSI required more re-operations and re-admissions, and eventually longer total hospital stays than incisional SSI (p = 0.036). Intra-abdominal abscess around the pancreas was the main cause of organ/space SSI, while no anastomotic leakage was observed. Multivariate analyses identified male gender (odds ratio (OR) 3.385; 95 % confidence interval (CI) 1.073-15.07, p = 0.037), chronic liver disease (OR 8.897; 95 % CI 2.502-28.99, p = 0.001), and total gastrectomy (TG) (OR 3.817; 95 % CI 1.380-10.24, p = 0.011) as independent risk factors for organ/space SSI, while TG (OR 3.130; 95 % CI 1.102-8.768, p = 0.033) and operation time ≥320 min (OR 3.732; 95 % CI 1.109-16.98, p = 0.033) were independently associated with incisional SSI.
  
  
  
  Male gender, chronic liver disease, and TG are independent risk factors for organ/space SSI after LG for GC; thus, meticulous surgical procedures need to be performed among patients with these specific risk factors.
authors: Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, Kyoto, 602-8566, Japan.
authors: Toshiyuki
authors: T
authors: Kosuga
authors: Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, Kyoto, 602-8566, Japan. ichikawa@koto.kpu-m.ac.jp.
authors: Daisuke
authors: D
authors: Ichikawa
authors: Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, Kyoto, 602-8566, Japan.
authors: Shuhei
authors: S
authors: Komatsu
authors: Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, Kyoto, 602-8566, Japan.|Department of Gastroenterological Surgery, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan.
authors: Takeshi
authors: T
authors: Kubota
authors: Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, Kyoto, 602-8566, Japan.
authors: Kazuma
authors: K
authors: Okamoto
authors: Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, Kyoto, 602-8566, Japan.
authors: Hirotaka
authors: H
authors: Konishi
authors: Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, Kyoto, 602-8566, Japan.
authors: Atsushi
authors: A
authors: Shiozaki
authors: Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, Kyoto, 602-8566, Japan.
authors: Hitoshi
authors: H
authors: Fujiwara
authors: Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, Kyoto, 602-8566, Japan.
authors: Eigo
authors: E
authors: Otsuji
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D010535:Laparoscopy / Q000009:adverse effects; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D012189:Retrospective Studies; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000453:epidemiology / Q000601:surgery*; D013530:Surgical Wound Infection / Q000453:epidemiology / Q000517:prevention & control*; D016896:Treatment Outcome
keywords: Comorbidity; Complication; Gastric cancer; Laparoscopic gastrectomy; Surgical site infection