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Right colon, left colon, and rectal surgeries are not similar for surgical site infection development. Analysis of 277 elective and urgent colorectal resections

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Abstract

Purpose

Surgical site infections (SSIs) are the most common infections in colorectal surgery. Although some studies suggest that rectal surgery differs from colon surgery for SSI incidence and risk factors, the National Nosocomial Infection Surveillance system categorizes all colorectal surgeries into only one group. The aim of this study was to determine incidence, characteristics, and risk factors of SSIs according to the subclassification of colorectal surgery into right colon surgery (RCS), left colon surgery (LCS), and rectum surgery (RS).

Methods

From November 2005 to July 2009, all patients requiring colorectal resectioning were enrolled into our program. The outcome of interest was an SSI diagnosis. Univariate and multivariate analyses were performed to determine SSI predictors in each group.

Results

Two hundred seventy-seven consecutive colorectal resections were analyzed. SSI rates were 8% in RCS, 18.4% in LCS, and 17.6% in RS. LCS and RS showed significantly higher SSI incidences (p = 0.022) and greater rates of organ/space infections compared to RCS (p = 0.029). Predictors of SSI were steroid use among RCS, age greater than 70 years, multiple comorbidities, steroid use, non-neoplastic colonic disease, urgent operation, ostomy creation, postoperative intensive care among LCS, preoperative chemoradiation, heart disease, and prolonged operation among RS patients. On multivariate analysis, the coupled LCS and RS groups showed an increased risk for SSI compared to RCS (OR, 2.57).

Conclusions

SSI incidences, characteristics, and risk factors seem to be different among RCS, LCS, and RS. A tailored SSI surveillance program should be applied for each of the three groups, leading to a more competent SSI recognition and reduction of SSI incidence and related costs.

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Competing interests

The authors declare that they have no competing interests.

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Authors and Affiliations

  1. Department of General Surgery, San Gerardo Hospital, University of Milano-Bicocca, Monza, Italy

    Luca Degrate, Mattia Garancini, Marta Misani, Silvia Poli, Cinzia Nobili, Fabrizio Romano, Vittorio Motta & Franco Uggeri

  2. Mario Negri Institute for Pharmacological Research, Milan, Italy

    Laura Giordano

  3. Department of General Surgery, San Gerardo Hospital, University of Milano-Bicocca, Via Pergolesi 33, 20052, Monza, Italy

    Luca Degrate

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  1. Luca Degrate
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  2. Mattia Garancini
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Correspondence to Luca Degrate.

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Degrate, L., Garancini, M., Misani, M. et al. Right colon, left colon, and rectal surgeries are not similar for surgical site infection development. Analysis of 277 elective and urgent colorectal resections. Int J Colorectal Dis 26, 61–69 (2011). https://doi.org/10.1007/s00384-010-1057-8

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  • DOI: https://doi.org/10.1007/s00384-010-1057-8

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