title: Infectious Complications after Cytoreductive Surgery and Hyperthermic Intra-Peritoneal Chemotherapy.
abstract: BACKGROUND
  The aim of this study was to review the post-operative and infectious complications and determine the risk factors associated with infections in cytoreductive surgery (CRS) and hyperthermic intra-peritoneal chemotherapy (HIPEC).
  
  
  METHODS
  Between October 2007 and December 2013, patients who underwent CRS and HIPEC with a curative intent were included in the study. The Centers for Disease Control and Prevention's National Nosocomial Infections Surveillance System definitions were used to identify post-operative nosocomial infections.
  
  
  RESULTS
  One hundred and sixty-nine CRS and HIPEC procedures were performed. Overall, 155 complications were observed in 82 (48.5%) patients. Grade 3-4 morbidity rate was 25.5% (n = 43). Seventy infections occurred in 47 patients. Surgical site infection was the most common infectious complication. The most common micro-organism isolated from the cultures was Escherichia coli. Age (odds ratio [OR]1.039, confidence interval [CI] 1.006-1.073), the mean total number of staff scrubbing in the operation(OR 2.241, CI 1.415-3.548), and intensive care unit stay (OR 1.325, CI 0.953-1.842) were independent risk factors for infectious complications.
  
  
  CONCLUSIONS
  Infectious complications are the most important cause of peri-operative morbidity and death in CRS and HIPEC. As well as patient and tumor characteristics, surgeon/center-related factors play an important role in infectious morbidity. Patients with peritoneal carcinomatosis should be considered as a complex oncologic group at high risk of infectious complications.
authors.affiliation: 1 Department of Colorectal Surgery, Liv Hospital Ulus , Istanbul, Turkey .
authors.forename: Naciye Cigdem
authors.initials: NC
authors.lastname: Arslan
authors.affiliation: 2 Department of General Surgery, Dokuz Eylul University , Izmir, Turkey .
authors.forename: Selman
authors.initials: S
authors.lastname: Sokmen
authors.affiliation: 3 Department of Infectious Diseases and Clinical Microbiology, Dokuz Eylul University , Izmir, Turkey .
authors.forename: Vildan
authors.initials: V
authors.lastname: Avkan-Oguz
authors.affiliation: 4 Department of Radiology, Faculty of Medicine, Dokuz Eylul University , Izmir, Turkey .
authors.forename: Funda
authors.initials: F
authors.lastname: Obuz
authors.affiliation: 2 Department of General Surgery, Dokuz Eylul University , Izmir, Turkey .
authors.forename: Aras Emre
authors.initials: AE
authors.lastname: Canda
authors.affiliation: 2 Department of General Surgery, Dokuz Eylul University , Izmir, Turkey .
authors.forename: Cem
authors.initials: C
authors.lastname: Terzi
authors.affiliation: 2 Department of General Surgery, Dokuz Eylul University , Izmir, Turkey .
authors.forename: Mehmet
authors.initials: M
authors.lastname: Fuzun
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use*; D065426:Cytoreduction Surgical Procedures / Q000009:adverse effects*; D005260:Female; D006801:Humans; D006979:Hyperthermia, Induced / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D010534:Peritoneal Neoplasms / Q000188:drug therapy* / Q000453:epidemiology / Q000601:surgery*; D012189:Retrospective Studies; D013530:Surgical Wound Infection / Q000453:epidemiology* / Q000401:mortality
chemical_list: D000970:Antineoplastic Agents
keywords: hyperthermic intra-peritoneal chemotherapy; infection; morbidity; oncology; peritoneal carcinomatosis