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Chinese Journal of Operative Procedures of General Surgery(Electronic Edition) ›› 2018, Vol. 12 ›› Issue (03): 211-214. doi: 10.3877/cma.j.issn.1674-3946.2018.03.011

Special Issue:

• Original Article • Previous Articles     Next Articles

Clinical analysis of abdominal physiological features in predicting surgical site infection of patients underwent colorectal cancer surgery

Song Liu1, Meng Wang1, Feng Wang1, Xiaofeng Lu1, Wenxian Guan1,(), Liming Zheng1,()   

  1. 1. Department of General Surgery, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Jiangsu 210008, China
  • Received:2018-03-31 Online:2018-06-26 Published:2018-06-26
  • Contact: Wenxian Guan, Liming Zheng
  • About author:
    Corresponding author: Guan Wenxian, Email:
    Zhang Liming, Email:
  • Supported by:
    National Natural Science Foundation of China(81602103); Natural Science Foundation of Jiangsu Province(BK20160114); Distinguished Young Scholar Project of Medical Science and Technology Development Foundation of Nanjing Department of Health(JQX17005); Key Project of Medical Science and Technology Development Foundation of Nanjing Department of Health(YKK16114); Medical Research Program of Jiangsu Provincial Commission of Health and Family Planning(Q2017007); Wu Jieping Medical Foundation(320.2710.1817)

Abstract:

Objective

Surgical site infection (SSI) is common postoperative complication after gastrointestinal surgery, could increase hospital stay and ecnomic and social burden. Therefore early prediction and intervention of SSI is important. The aim this study is to investigate the association between abdominal physiological features (including subcutaneous fat thickness (SFT), rectus abdominis thickness (RAT) and abdomen depth) and the occurrence of SSI in patients receiving radical resection of colorectal cancer.

Methods

We conducted a retrospective case-control study. All patients were divided into SSI or non-SSI groups using propensity score match. All statistical analysis was performed by using GraphPad Prism version 7.0 and SPSS version 23.0. Demographics, clinical characteristics, periopeartive data were compared between groups. Continuous variables were presented as (±s) and compared by using independent t test. Categorical variables were presented as percentage (%) and were compared by using Chi-square test. Significant elements were subsequently brought into logistic regression and receiver-operating characteristic analysis for further identification.

Results

A total of 374 patients were enrolled, and 55 patients in each group were eventually matched. Gender, age, BMI, previous surgical history, tobacco usage history, concomitant disease, incision classification, ASA score, tumor location and pathological stage were all similar between groups. Patients in SSI group exhibited lower preoperative albumin [(36.6±3.9) g/L vs. (39.2±3.6) g/L, P=0.002)], higher RAT [(9.4±2.7) mm vs.(8.1±2.1) mm, P=0.014)], AD [(82.3±23.6) mm vs. (71.7±23.8) mm, P=0.029)] and the multiplied value (RAT×AD) (P=0.002) compared to patients in non-SSI group. RAT×AD was an independent risk factor for SSI (OR=1.007, P<0.001), and could serve as a biomarker for SSI prediction (AUC=0.83, 95%CI: 0.74~0.91) in this cohort of patients.

Conclusions

Preoperative rectus abdominis thickness and abdomen depth correlate with the risk of postoperative SSI in patients receiving elective radical resection of colon cancer.

Key words: Colonic Neoplasms, Colectomy, Surgical Wound Infection, Rectus Abdominis, Abdominal Cavity

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