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Differences in surgical site infection between laparoscopic colon and rectal surgeries: sub-analysis of a multicenter randomized controlled trial (Japan-Multinational Trial Organization PREV 07-01)

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Abstract

Background

The incidence of surgical site infection (SSI) is reportedly lower in laparoscopic colorectal surgery than in open surgery, but data on the difference in SSI incidence between colon and rectal laparoscopic surgeries are limited.

Methods

The incidence and risk factors for SSI, and the effect of oral antibiotics in colon and rectal laparoscopic surgeries, were investigated as a sub-analysis of the JMTO-PREV-07-01 (a multicenter, randomized, controlled trial of oral/parenteral vs. parenteral antibiotic prophylaxis in elective laparoscopic colorectal surgery).

Results

A total of 582 elective laparoscopic colorectal resections, comprising 376 colon surgeries and 206 rectal surgeries, were registered. The incidence of SSI in rectal surgery was significantly higher than in colon surgery (14 vs. 8.2 %, P = 0.041). Although the incidence of incisional SSI was almost identical (7 %) between the surgeries, the incidence of organ/space SSI in rectal surgery was significantly higher than in colon surgery (6.3 vs. 1.1 %, P = 0.0006). The lack of oral antibiotics was significantly associated with the development of SSI in colon surgery. Male sex, stage IV cancer, and abdominoperineal resection were significantly associated with SSI in rectal surgery. The combination of oral and parenteral antibiotics significantly reduced the overall incidence of SSI in colon surgery (relative risk 0.41, 95 % confidence interval 0.19–0.86).

Conclusion

The incidence of SSI in laparoscopic rectal surgery was higher than in colon surgery because of the higher incidence of organ/space SSI in rectal surgery. The risk factors for SSIs and the effect of oral antibiotics differed between these two procedures.

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Acknowledgments

We thank all patients and their relatives for their willingness to participate in the study and the study team at the five facilities for their cooperation with case registration. We also thank Ms. Yuriko Hayashi for her great assistance in data management.

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Authors and Affiliations

  1. Department of Surgery, Graduate School of Medicine, Kyoto University, 54 Shogoin-Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan

    Saori Goto, Suguru Hasegawa, Koya Hida & Yoshiharu Sakai

  2. Department of Surgery, National Hospital Organization, Kyoto Medical Center, Kyoto, Japan

    Hiroaki Hata & Takashi Yamaguchi

  3. Department of Surgery, Digestive Disease Center, Kyoto Katsura Hospital, Kyoto, Japan

    Ryuta Nishitai

  4. Department of Surgery, Osaka Red Cross Hospital, Osaka, Japan

    Satoshi Yamanokuchi

  5. Department of Surgery, Faculty of Medicine, Saga University, Saga, Japan

    Akinari Nomura

  6. Department of Biostatistics, Yokohama City University School of Medicine, Yokohama, Japan

    Takeharu Yamanaka

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  1. Saori Goto
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  2. Suguru Hasegawa
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  3. Hiroaki Hata
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  4. Takashi Yamaguchi
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  5. Koya Hida
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Corresponding author

Correspondence to Saori Goto.

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The authors declare that they have no conflicts of interest.

Source of funding

This study was funded by the Japan-Multinational Trial Organization (JMTO), which is a general incorporated association established in 1999 to support clinical trials, especially multicenter or multinational randomized controlled trials, for the diagnosis, treatment, and prevention of diseases.

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Goto, S., Hasegawa, S., Hata, H. et al. Differences in surgical site infection between laparoscopic colon and rectal surgeries: sub-analysis of a multicenter randomized controlled trial (Japan-Multinational Trial Organization PREV 07-01). Int J Colorectal Dis 31, 1775–1784 (2016). https://doi.org/10.1007/s00384-016-2643-1

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  • DOI: https://doi.org/10.1007/s00384-016-2643-1

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