Prognostic significance of postoperative septic complications in surgery of rectal carcinoma

AIM: To assess whether there is a correlation between the onset of postoperative sepsis and the 5-years survival rate in patients undergoing surgery for rectal cancer. EXPERIMENTAL DESIGN: A retrospective study of all patients, undergoing rectal cancer surgery during the period January 1981-December 1987. PLACE: General Surgery Unit, Hospital Arnau de Vilanova. PATIENTS: All patients operated with Duke's stage B and C colorectal neoplasms, excluding cases with postoperative complications not directly correlated to surgery: pneumonia, thromboblebitis, urinary infection or fever of unknown origin. FINDINGS: Postsurgical complications distinguished as minor (wall abscess) or major (anastomotic dehiscence, peritoneal abscess). 5-year survival rate. RESULTS: The actuarial 5-year survival rate of patients with major septic complications was significantly lower (p < 0.05) than that in noncomplicated cases. No difference was observed in the survival of patients with and without minor septic complications. CONCLUSION: Major septic complications secondary to colorectal surgery are still a threat in spite of improved techniques and antibiotic prophylaxis, and negatively influence the long-term survival rate.