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Comparative analysis of the incidence of surgical site infections in patients with liver resection for colorectal hepatic metastases after neoadjuvant chemotherapy
Authors:Roberto Scilletta,Duilio Pagano,Marco Spada,Sebastiano Mongiovì  ,Antonio Pesce,Teresa R. Portale,Vincenzo Guardabasso,Stefano Puleo,Salvatore Gruttadauria
Affiliation:1. Department of Surgical Sciences, University of Catania, Azienda Ospedaliero - Universitaria Policlinico - Vittorio Emanuele, Catania, Italy;2. Department of Surgery, University of Pittsburgh, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (ISMETT), University of Pittsburgh Medical Center in Italy, Palermo, Italy;3. Department of Abdominal Oncology Surgery, Humanitas Centro Catanese di Oncologia, Catania, Italy;4. Azienda Ospedaliero - Universitaria Policlinico - Vittorio Emanuele, Catania, Italy
Abstract:

Background

The aim of this study was to identify the incidence of surgical site infections (SSIs) and postoperative complications, as defined by the Clavien–Dindo classification, after hepatic resection for metastatic colorectal cancer in patients with and without associated neoadjuvant chemotherapy.

Methods

A total of 181 patients were studied retrospectively. Patients were divided into two groups: the first group comprised patients with associated neoadjuvant chemotherapeutic treatment for liver metastases with a latency time <8 wk and the second group comprised patients without associated neoadjuvant chemotherapy.

Results

Variables of duration of liver surgery, length of total hospital stay, and length of postoperative hospital stay seem to be correlated with SSIs and postoperative complications, P < 0.005 and P < 0.0001, respectively. Duration of surgery is a risk factor for SSIs, with an odds ratio of 1.15, and for complications according to the Clavien–Dindo classification, with an odds ratio of 1.35.

Conclusions

Neoadjuvant chemotherapy was not a significant risk factor for SSIs, whereas the total length of hospital stay, length of postoperative hospital stay, and duration of surgery were independent predictors of SSIs and complications according to the Clavien–Dindo classification.
Keywords:Colorectal liver metastases   Surgical site infection   Clavien&ndash  Dindo classification   Neoadjuvant chemotherapy   Liver surgery   Risk factors
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