Operation time and body mass index are significant risk factors for surgical site infection in laparoscopic sigmoid resection: a multicenter study

Surg Endosc. 2011 Nov;25(11):3531-4. doi: 10.1007/s00464-011-1753-7. Epub 2011 Jun 3.


Background: Surgical site infection (SSI) in patients who underwent colorectal surgery is a common complication associated with increased morbidity and costs. The aim of this study was to assess risk factors for SSI in laparoscopic sigmoid resection for benign disease.

Methods: Using a multicenter database of the Swiss Association of Laparoscopic and Thoracoscopic Surgery, we prospectively identified 4,488 patients who underwent laparoscopic colorectal surgery between 1995 and 2008; of these, 2,571 patients who underwent sigmoid resection for benign disease were included. Uni- and multivariate analyses were used to determine risk factors for SSI.

Results: The incidence of SSI was 3.5% (90/2,571). Among SSI patients, incisional superficial infections were found in 71%, incisional deep infections in 22%, and organ-space infections in 7%. Patients' age, underlying disease, and surgeons' experience had no impact on SSI. Multivariate analyses showed that operation time >240 min (odds ratio [OR] 1.7; 95% confidence interval [CI] 1.0-2.8), BMI ≥ 27 kg/m(2) (OR 2.3 [1.3-4.5]), organ lesions (OR 7.9 [2.0-31.8]), and male gender (OR 2.3 [1.2-4.5]) were significant risk factors for SSI. Reoperations in the SSI group were significantly more frequent than in the Non-SSI group (30% vs. 3%; p < 0.001). SSI was associated with a significantly longer median hospital stay (15 days, range = 2-69 vs. 8 days, range = 1-69; p < 0.001) and higher mortality rate (2.2% vs. 0.4%; p = 0.019).

Conclusion: Significant risk factors for SSI were operation time > 240 min, BMI ≥ 27 kg/m(2), organ lesions, and male gender. SSI was significantly associated with more reoperations, longer hospital stay, and higher mortality rate.

Publication types

  • Multicenter Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Body Mass Index*
  • Colon, Sigmoid / surgery*
  • Female
  • Humans
  • Intraoperative Complications
  • Laparoscopy*
  • Male
  • Middle Aged
  • Postoperative Complications
  • Risk Factors
  • Sigmoid Diseases / surgery*
  • Surgical Wound Infection / etiology*
  • Young Adult