Risks and outcomes of surgical site infection after minimally invasive colorectal surgery: a Japanese multicenter study.

PURPOSE: Studies evaluating the occurrence, risk factors, and prognostic impact of surgical site infection (SSI) after minimally invasive surgery (MIS) for colorectal cancer are limited.

METHODS

This multicenter retrospective study reviewed 3276 consecutive patients who underwent curative MIS for colorectal cancer between 2016 and 2024. Patients were divided into those who experienced incisional/deep SSI (n = 71), organ/space SSI (n = 67), and no SSI (no-SSI, n = 3138). This cohort was further subdivided into colon and rectum groups, and we examined the clinicopathological background and risk factors using a logistic regression analysis and prognosis using a Cox proportional hazards analysis.

RESULTS

In colon cancer, blood loss was an independent predictor of incisional/deep SSI (odds ratio (OR) 1.745, p = 0.042) and organ/space SSI (OR 6.087, 95% CI, 1.319-28.087; p = 0.020). In rectal cancer, preoperative treatment was an independent predictor of incisional/deep SSI (OR 5.619, p < 0.001) and organ/space SSI (OR 2.552, p = 0.021). In pathological node-negative patients with colon cancer, RFS (5-year RFS; 76.4% vs. 27.2% vs. 82.6%, p < 0.001) and OS (5-year OS; 80.0% vs. 56.0% vs. 86.4%, p = 0.013) were worse in the organ/space SSI group.

CONCLUSIONS

Preoperative treatment and blood loss are risk factors for SSI. Even after SSI, administering appropriate adjuvant chemotherapy may be important for improving the prognosis.