Risk factors for surgical site infection after elective resection for rectal cancer. A multivariate analysis on 2131 patients.

Aim: Surgical site infection (SSI) is the most common cause of morbidity after colorectal surgery. The aim of this study was to analyze risk factors for SSI in patients who had undergone surgery for rectal cancer.

Method: A multicentre observational study was carried out on 2131 patients operated on for rectal cancer between May 2006 and May 2009. Twenty-nine centres were involved. SSI included wound infection and organ space infection within 30 days after the operation. Univariate and multivariate analyses were carried out to study possible risk factors for SSI.

Results: Wound infection and organ space infection were diagnosed in 8.9% and 10%, respectively, of patients. The anastomotic leakage rate was 8%. Multivariate analysis showed that wound infection was related to tumour stage, a converted laparoscopic procedure and open surgery. Organ space infection was related to Stage IV tumour, a tumour < 11 cm from the anal verge, low anterior resection and Hartmann's procedure.

Conclusion: Rectal surgery for malignant disease is associated with a considerable rate of SSI. Wound infection and organ space infection are related to different factors and therefore should be evaluated separately.