-Original-

Postoperative Infection after Colorectal Surgery: Subanalysis of Data from the 2015 Japan Postoperative Infectious Complications Survey

Hiroshi Maruyama¹, Shinya Kusachi², Hiroshi Makino¹, Hitoshi Kanno³, Hiroshi Yoshida³ and Toru Niitsuma⁴

¹Department of Surgery, Nippon Medical School Tama Nagayama Hospital, Tokyo, Japan
²Tohokamagaya Hospital, Chiba, Japan
³Department of Digestive Surgery, Nippon Medical School Hospital, Tokyo, Japan
⁴Department of Surgery, Toho University Ohashi Medical Center, Tokyo, Japan

Background: Most surveillance programs for postoperative infection focus on surgical site infections (SSI). However, postoperative remote infections are of emerging clinical importance. Using data from a multicenter survey administered to patients who underwent gastrointestinal surgery, we investigated the incidence of SSI and remote infection after colorectal surgery.
Methods: From September 2015 through March 2016, 1,724 patients underwent colorectal surgery in 28 affiliated centers in Japan. We retrospectively recorded patient age, sex, surgical site, surgical approach, wound classification, performance status at discharge, and postoperative infection status.
Results: Postoperative infection was noted in 236 (13.7%) patients; 150 and 86 patients underwent colon and rectal surgeries, respectively (incidence of postoperative infection: 13.7% and 14.8%). The incidence of postoperative infection was significantly lower after laparoscopic surgery than after open surgery, in colon and rectal surgery (p < 0.001). Among patients with postoperative infections, 211 (89.4%) had a single infection and 25 (10.6%) had multiple infections. Among patients with a single postoperative infection, SSI and remote infection occurred in 143 (60.6%) and 68 (28.8%) patients, respectively. The most common multiple postoperative infections were "incisional and organ/space SSIs" and "organ/space SSI and bacteremia of unknown origin" (n = 3 each).
Conclusions: This study revealed the prevalence distributions for postoperative SSI and remote infections. Because of the substantial effect of remote infections on patient quality of life and the associated social burden, prospective periodic surveillance for SSI and remote infection is necessary for careful evaluation and prevention.

J Nippon Med Sch 2020; 87: 204-210

Keywords
postoperative infection, surgical site infection, remote infection, colorectal surgery

Correspondence to
Hiroshi Maruyama, Department of Surgery, Nippon Medical School Tama Nagayama Hospital, 1-7-1 Nagayama, Tama, Tokyo 206-8512, Japan
maruchan@nms.ac.jp

Received, September 30, 2019
Accepted, December 12, 2019