Surgical Site Infection of Rectal Cancer Patients Undergoing Total Pelvic Exenteration

Abstract

We retrospectively evaluated the incidence of surgical site infection (SSI) of 12 rectal cancer patients undergoing total pelvic exenteration (TPE) between January 1997 and March 2012, and compared with that of 19 rectal cancer patients undergoing anterior or posterir pelvic exenteration (A/PPE) or 79 rectal cancer patients undergoing abdomino-perineal resection (APR). Furthermore, the risk factors of SSI for all the patients were analyzed. The incidence of overall SSI was not significantly different between the three groups (TPE: 58.3%, A/PPE: 52.6%, and APR: 39.2%, p=0.32). The incidence of incision site infection (IS) of patients undergoing APR (19.0%) was significantly lower than that of patients undergoing TPE (41.7%) and A/PPE (42.1%) (p=0.05). The incidence of organ/space infection (OS) was not significantly different between the three groups (TPE: 33.3%, A/PPE: 31.6%, and APR: 20.3%, p=0.41). On multivariate logistic regression analysis, only blood loss was an independent significant factor affecting the overall SSI (p=0.04), only passive drainage was an independent significant factor affecting the IS (p<0.01), and passive drainage and duration of intravenous antibiotics use were independent significant factors affecting the OS. TPE does not increase the risk of SSI as compared with A/PPE or APR for rectal cancer patients. However, it is necessary to take measures against SSI common to the surgical procedures which extensive dead space produces in a pelvis cavity including TPE.