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Published in:

01-04-2017

Clinical and surgical factors associated with organ/space surgical site infection after laparoscopic gastrectomy for gastric cancer

Authors: Toshiyuki Kosuga, Daisuke Ichikawa, Shuhei Komatsu, Takeshi Kubota, Kazuma Okamoto, Hirotaka Konishi, Atsushi Shiozaki, Hitoshi Fujiwara, Eigo Otsuji

Published in: Surgical Endoscopy | Issue 4/2017

Abstract

Background

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.

Methods

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.

Results

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.

Conclusions

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.

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Title: Clinical and surgical factors associated with organ/space surgical site infection after laparoscopic gastrectomy for gastric cancer
Authors: Toshiyuki Kosuga
Daisuke Ichikawa
Shuhei Komatsu
Takeshi Kubota
Kazuma Okamoto
Hirotaka Konishi
Atsushi Shiozaki
Hitoshi Fujiwara
Eigo Otsuji
Publication date: 01-04-2017
Publisher: Springer US
Published in: Surgical Endoscopy / Issue 4/2017
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-016-5156-7

At a glance: The STEP trials

Springer Medicine

Clinical and surgical factors associated with organ/space surgical site infection after laparoscopic gastrectomy for gastric cancer

Abstract

Background

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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