Abstract
AIM: Previous studies have examined bowel preparation as a measure to reduce surgical site infection (SSI) rates. This retrospective study aimed to identify the risk factors for SSI in right-sided colon cancer surgery using intracorporeal anastomosis (IA). We focused on perioperative factors, including the bowel preparation method, to clarify the impact of preoperative mechanical bowel preparation (MBP) and oral antibiotics (OA) on SSI incidence. METHODS: Patients (n = 150) with right-sided colon cancer who underwent elective laparoscopic or robot-assisted colectomy (2019 and 2023) were included. Potential risk factors for SSI were examined using univariate and multivariate analyses. RESULTS: The overall incidence of SSI was 11 (7.3%) cases, with eight (5.4%) cases classified as incision site SSI and three (1.9%) as organ/space SSI. Univariate analysis showed that OA (p < 0.001) and MBP (p = 0.002) significantly reduced the SSI rate. Multivariate analysis identified OA as an independent risk factor (hazard ratio, 0.142; 95% confidence interval, 0.025-0.827; p = 0.025). Patients with SSI had longer postoperative hospital stays compared to those without SSI (median 9 vs. 8 days, p = 0.012). On postoperative day 1, the group receiving OA had significantly lower white blood cell count (9390 vs. 10 900/μL, p = 0.005) and C-reactive protein levels (3.81 vs. 7.83 mg/dL, p < 0.001) compared to those in the group not receiving OA. CONCLUSION: Preoperative administration of OA in laparoscopic or robot-assisted right-sided colon cancer surgery with IA may help decrease the incidence of SSI.