Risk Factors for Tissue and Wound Complications in Gastrointestinal Surgery

Sørensen, Lars Tue; Hemmingsen, Ulla; Kallehave, Finn; Wille‐Jørgensen, Peer; Kjærgaard, J; Möller, Luciana M.; Jørgensen, Torben

doi:10.1097/01.sla.0000157131.84130.12

Cited by 226 publications

(166 citation statements)

References 36 publications

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“…Data from previous study demonstrated that baccy had been shown to impair tissue healing and increase the risk of wound complications and AL after gastrointestinal surgery (Kasperk et al, 2000;Sorensen et al, 2005). However, the current study provide evidence that smoking is not a independent factor of AL after the multivariate analysis.…”

Section: Discussioncontrasting

confidence: 51%

Risk Assessment on Anastomotic Leakage after Rectal Cancer Surgery: An Analysis of 753 Patients

Liu¹,

Huang²,

Zhou³

2013

Asian Pacific Journal of Cancer Prevention

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Purpose: To investigate the risk factors for anastomotic leakage (AL) after anterior resection for rectal cancer with a double stapling technique. Patients and Methods: Between January 2004 and December 2011, 753 consecutive patients in Jiangsu Cancer Hospital and Research Institute diagnosed with rectal cancer and undergoing anterior resection with a double stapling technique were recruited. All patients experienced a total mesorectal excision (TME) operation. Additionally, decrease of postoperative tumor supplied group of factors (TSGF), which have not been reported before, was proposed as a new indicator for AL. Univariate and multivariate analysis were performed to determine risk factors for AL. Results: AL was detected in 57 (7.6%) of 753 patients with rectal cancer. The diagnosis of anastomotic leakage was confirmed between the 6th and 12th postoperative day (POD; mean 8th POD). After univariate analysis and multivariate analysis, age (p<0.001), gender (p=0.002), level of anastomosis (p < 0.001), preoperative body mass index (BMI) (p = 0.001) and reduction of TSGF in 5th POD was less than 10 m/ml (p < 0.001) were selected as 5 independent risk factors for AL. It was also indicated that a temporary defunctioning transverse ileostomy (p = 0.04) would decrease the occurrence of AL. Conclusion: AL after anterior resection for rectal carcinoma is related to elderly status, low level site of the tumor (below the peritoneal reflection), being male, preoperative BMI and the decrease of TSGF in 5 th POD is less than 10 m/ml. Preventive ileostomy is advisable after TME for low rectal tumors to prevent AL.

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Section: Discussioncontrasting

confidence: 51%

Risk Assessment on Anastomotic Leakage after Rectal Cancer Surgery: An Analysis of 753 Patients

Liu¹,

Huang²,

Zhou³

2013

Asian Pacific Journal of Cancer Prevention

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“…Reoperation is well known as a major predictor of tissue and wound complications, or SSI, in gastrointestinal surgery. 22 ' 23 This is presumably due to the effect of longer exposure to the risk of bacterial contamination and impaired healing of the relatively avascular scar tissue of the previous incisional wound. 24 Concurrent multiple surgical procedures were also a major risk factor for SSI after gastric surgery in another study.…”

Section: Discussionmentioning

confidence: 99%

Prospective Nationwide Surveillance of Surgical Site Infections after Gastric Surgery and Risk Factor Analysis in the Korean Nosocomial Infections Surveillance System (KONIS)

Kim

Song

et al. 2012

Infect. Control Hosp. Epidemiol.

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'" for the Korean Nosocomial Infections Surveillance System (KONIS)OBJECTIVE. To evaluate the risk factors for surgical site infection (SSI) after gastric surgery in patients in Korea. DESIGN. A nationwide prospective multicenter study.SETTING. Twenty university-affiliated hospitals in Korea.METHODS. The Korean Nosocomial Infections Surveillance System (KONIS), a Web-based system, was developed. Patients in 20 Korean hospitals from 2007 to 2009 were prospectively monitored for SSI for up to 30 days after gastric surgery. Demographic data, hospital characteristics, and potential perioperative risk factors were collected and analyzed, using multivariate logistic regression models.RESULTS. Of the 4,238 case patients monitored, 64.9% (2,752) were male, and mean age (±SD) was 58.8 ( ± 12.3) years. The SSI rates were 2.92, 6.45, and 10.87 per 100 operations for the National Nosocomial Infections Surveillance system risk index categories of 0, 1, and 2 or 3, respectively. The majority (69.4%) of the SSIs observed were organ or space SSIs. The most frequently isolated microorganisms were Staphylococcus aureus and Klebsiella pneumoniae. CONCLUSIONS. Male sex, inappropriate SAP, and operation-related variables are independent risk factors for SSI after gastric surgery. Infect Control Hosp Epidemiol 2012;33(6):572-580Surgical site infections (SSIs) are the leading cause of noslance system for nosocomial infections, the Korean Nosoocomial infection. The development of SSIs results in procomial Infections Surveillance System (KONIS), was devellonged hospital stay, extra costs, and increased morbidity and oped in Korea in 2006. 5 Gastric surgery was one of the most mortality. 1,2 A system for infection surveillance and to provide frequently performed surgical procedures in Korea in 2009 feedback to practicing surgeons regarding infection rates was (39.64 operations per 100,000 population); 6 when employing effective in reducing rates of SSI in previous studies. 3 ' 4 In surveillance for SSIs and risk factor analyses in Korea, gastric addition, it is important to establish the risk factors for SSI, surgery was given priority over other surgical procedures. A to prevent infectious complications after surgery by improvnumber of studies have shown that wound class, patient age, ing correctable factors.body mass index (BMI), duration of operation, laparoscopic A nationwide prospective multicenter Web-based surveilprocedure, and multiple doses of prophylactic antibiotics Affiliations:

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“…However, the length of smoking cessation necessary to reduce AL is still debatable. Sørensen et al conducted a randomized controlled trial (RCT) and reported that two weeks of smoking cessation was not enough to reduce complications after colorectal resection 24) . On the other hand, a recent meta-analysis showed that at least three to four weeks of smoking cessation reduced wound-healing complications 25) .…”

Section: Discussionmentioning

confidence: 99%

Smoking and tumor obstruction are risk factors for anastomotic leakage after laparoscopic anterior resection during rectal cancer treatment

Matsuzaki

Ishihara

Kawai

et al. 2017

J Anus Rectum Colon

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Abstract:Objectives: To clarify the surgical outcomes and risk factors for anastomotic leakage (AL) following laparoscopic anterior resection (Lap-AR) for the treatment of rectal cancer. Methods: We retrospectively reviewed the records of 175 consecutive primary rectal cancer patients who had undergone Lap-AR at our institution between April 2012 and November 2015. Patient, tumor, and surgical variables were analyzed using univariate analyses. Results: Of 175 patients, 116 were men (66.3%). All four patients who had AL (2.3%) were men and current smokers with heavy smoking histories. In three of the AL cases, preoperative total colonoscopy was impossible owing to tumor obstruction, and the other case had concomitant obstructive colitis after oral bowel preparation. Univariate analysis identified tumor size, tumor obstruction, and smoking history as factors significantly associated with AL development. Conclusions: Tumor size, tumor obstruction, and smoking history were risk factors for AL following Lap-AR for the treatment of primary rectal cancer.

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Risk Factors for Tissue and Wound Complications in Gastrointestinal Surgery

Abstract: Factors known to affect the process of tissue and wound healing are independently associated with tissue and wound complications following gastrointestinal surgery.

Cited by 226 publications

References 36 publications

Risk Assessment on Anastomotic Leakage after Rectal Cancer Surgery: An Analysis of 753 Patients

Risk Assessment on Anastomotic Leakage after Rectal Cancer Surgery: An Analysis of 753 Patients

Prospective Nationwide Surveillance of Surgical Site Infections after Gastric Surgery and Risk Factor Analysis in the Korean Nosocomial Infections Surveillance System (KONIS)

Smoking and tumor obstruction are risk factors for anastomotic leakage after laparoscopic anterior resection during rectal cancer treatment

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