Sistema de Salut de Catalunya
[Matallana C] Departament de Cirurgia, Universitat Autònoma de Barcelona, Bellaterra, Spain. Servei de Cirurgia General i de l’Aparell Digestiu, Hospital Universitari Parc Taulí, Sabadell, Spain. Institut Català d’Oncologia (ICO), Hospital Duran i Reyals, L’Hospitalet de Llobregat, Spain. [Manchon-Walsh P, Borràs JM, Aliste L, Font R] Institut Català d’Oncologia (ICO), Hospital Duran i Reyals, L’Hospitalet de Llobregat, Spain. Institut d’Investigació Biomèdica de Bellvitge (IDIBELL), Universitat de Barcelona, L’Hospitalet de Llobregat, Spain. [Espín E] Unitat de Cirurgia de Còlon i Recte, Hospital Universitari Vall d’Hebron, Barcelona, Spain. [Pasqual M, Jiménez-Toscano M] Servei de Cirurgia, Hospital del Mar, Barcelona, Spain. [Biondo S] Servei de Cirurgia General i de l’Aparell Digestiu, Hospital Universitari de Bellvitge, Barcelona, Spain. [Badia JM] Servei de Cirurgia General i Digestiva, Hospital General de Granollers, Granollers, Spain. Facultat de Medicina, Universitat Internacional de Catalunya, Barcelona, Spain. Programa de Vigilància de les Infeccions Relacionades amb l’Atenció Sanitària a Catalunya (Programa VINCat) Servei Català de la Salut, Departament de Salut, Generalitat de Catalunya, Barcelona, Spain. [Limón E] Programa de Vigilància de les Infeccions Relacionades amb l’Atenció Sanitària a Catalunya (Programa VINCat) Servei Català de la Salut, Departament de Salut, Generalitat de Catalunya, Barcelona, Spain. Departament d’Infermeria de Salut Pública, Salut Mental i Maternoinfantil, Facultat d’Infermeria, Universitat de Barcelona, Barcelona, Spain. Centro de Investigacion Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto Carlos III, Madrid, Spain. [Pera M] Servei de Cirurgia General i Digestiva, Institut Clínic de Malalties Digestives i Metabòliques (ICMDM) Hospital Clínic Barcelona, Universitat de Barcelona, Barcelona, Spain. Grup de Recerca en Oncologia Gastrointestinal i Pancreàtica, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
Departament de Salut
2025-07-21T10:20:59Z
2025-07-21T10:20:59Z
2025-05-07
Surgical Wound Infection; Transanal Endoscopic Surgery; Cohort Studies
Infecció de la Ferida Quirúrgica; Cirurgia Endoscòpica Transanal; Cancer rectal
Infección de la Herida Quirúrgica; Cirugía Endoscópica Transanal; Cancer rectal
Anastomotic leak and subsequent organ/space surgical site infection (O/S-SSI) after colorectal cancer surgery are associated with poor short-term outcomes; however, the evidence regarding long-term outcomes is inconclusive. This population-based retrospective cohort study aimed to evaluate the association between O/S-SSI and both tumour recurrence and long-term survival after curative rectal cancer surgery. Data was obtained for all adults who underwent curative oncological resection of the rectum in the periods 2011-2012 and 2015-2016 (n = 2208) in Spain. Multivariable analysis (Cox proportional hazards model) was used to evaluate the effects of clinical and pathological characteristics, as well as the occurrence of O/S-SSI, on recurrence and survival. In all, 2208 adults underwent curative rectal cancer resection, 1464 of whom were male (66.3%); the median patient age was 69.1 years. O/S-SSI occurred in 291 patients (13%). Independent predictors of recurrence included tumour stage III (hazard ratio (HR) 1.95, 95% confidence interval (c.i.) 1.06 to 3.58; P = 0.032), a positive resection margin (HR 4.03, 95% c.i. 2.58 to 6.29; P < 0.001), and poor quality mesorectal excision (HR 1.81, 95% c.i. 1.11 to 2.95; P = 0.018), but not O/S-SSI (HR 1.02, 95% c.i. 0.78 to 1.34; P = 0.888). However, O/S-SSI was independently associated with reduced overall survival at 1 year (HR 2.20, 95% c.i. 1.39 to 3.48; P < 0.001), 2 years (HR 1.75, 95% c.i. 1.25 to 2.43; P < 0.001), and 5 years (HR 1.33, 95% c.i. 1.05 to 1.68; P = 0.017). In this study, O/S-SSI had a negative impact on the long-term survival of patients who underwent rectal cancer surgery, but was not associated with increased tumour recurrence.
This research was funded by the Departament de Recerca i Universitats de la Generalitat de Catalunya i l’AGAUR” (Grant number 2021 SGR 00808).
Article
English
Còlon - Càncer; Cirurgia - Complicacions; Infecció - Estudi de casos; DISEASES::Neoplasms::Neoplasms by Site::Digestive System Neoplasms::Gastrointestinal Neoplasms::Intestinal Neoplasms::Colorectal Neoplasms; DISEASES::Bacterial Infections and Mycoses::Infection::Wound Infection::Surgical Wound Infection; ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics::Epidemiologic Studies::Cohort Studies; DISEASES::Neoplasms::Neoplasms by Site::Digestive System Neoplasms::Gastrointestinal Neoplasms::Intestinal Neoplasms::Colorectal Neoplasms::Rectal Neoplasms; Other subheadings::Other subheadings::Other subheadings::/pathology; ENFERMEDADES::neoplasias::neoplasias por localización::neoplasias del sistema digestivo::neoplasias gastrointestinales::neoplasias intestinales::neoplasias colorrectales; ENFERMEDADES::infecciones bacterianas y micosis::infección::infección de heridas::infección de la herida quirúrgica; TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::técnicas de investigación::métodos epidemiológicos::características de los estudios epidemiológicos::estudios epidemiológicos::estudios de cohortes; ENFERMEDADES::neoplasias::neoplasias por localización::neoplasias del sistema digestivo::neoplasias gastrointestinales::neoplasias intestinales::neoplasias colorrectales::neoplasias del recto; Otros calificadores::Otros calificadores::Otros calificadores::/patología
Oxford University Press
BJS Open;9(3)
https://www.doi.org/10.1093/bjsopen/zraf052
Attribution-NonCommercial 4.0 International
Attribution-NonCommercial 4.0 International
http://creativecommons.org/licenses/by-nc/4.0/
