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What Is the Effect of Stoma Construction on Surgical Site Infection After Colorectal Surgery?

  • Original Article
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Journal of Gastrointestinal Surgery Aims and scope

Abstract

Introduction

The aim of our study was to evaluate the effect of stoma creation on deep and superficial surgical site infections after an index colorectal surgical procedure.

Methods

We designed a retrospective cohort study from the National Surgical Quality Improvement Program. We evaluated all patients who underwent colorectal surgery procedures from January 2005 to December 2009 with or without creation of a stoma and sought to identify the effect of stoma creation on deep and superficial surgical site infections.

Results

A total of 79,775 patients underwent colorectal procedures (laparoscopic 30.7 %, open 69.3 %), while 8,113 patients developed a surgical site infection (10.2 %). The univariate analysis revealed that surgical site infections were much more common in patients with a stoma compared to those with no stoma (11.8 % vs. 9.5 %, p < 0.0001). On multivariate analysis, stoma construction during the index colorectal procedure (OR 1.3, CI 1.2 to 1.4), ASA class ≥2, smoking, and abnormal body mass index were associated with surgical site infection.

Conclusions

The construction of a stoma with colorectal procedures is associated with a higher risk of surgical site infection. Although the stoma effect on surgical site infection is attenuated with laparoscopic techniques, the association remained statistically significant.

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Financial Disclosures

None.

Disclaimer

The ACS-NSQIP and the hospitals participating in the ACS-NSQIP are the source of the data used herein; they have not verified and are not responsible for the statistical validity of the data analysis or the conclusions derived by the authors. The study has been approved by all authors in the present format.

Funding

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Authors and Affiliations

  1. Department of Colon and Rectal Surgery, Lahey Clinic, 41 Mall Road, Burlington, MA, 01805, USA

    Rocco Ricciardi, Patricia L. Roberts, Jason F. Hall, Thomas E. Read, Todd D. Francone, Scott N. Pinchot, David J. Schoetz & Peter W. Marcello

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  1. Rocco Ricciardi
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  2. Patricia L. Roberts
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  3. Jason F. Hall
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Corresponding author

Correspondence to Rocco Ricciardi.

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Ricciardi, R., Roberts, P.L., Hall, J.F. et al. What Is the Effect of Stoma Construction on Surgical Site Infection After Colorectal Surgery?. J Gastrointest Surg 18, 789–795 (2014). https://doi.org/10.1007/s11605-013-2439-3

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  • DOI: https://doi.org/10.1007/s11605-013-2439-3

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