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Year : 2013  |  Volume : 3  |  Issue : 2  |  Page : 92-96

Surgical site infection following colorectal cancer surgery: Observations from Zaria, Northern Nigeria

Department of Surgery, Ahmadu Bello University Teaching Hospital, Zaria, Nigeria

Correspondence Address:
Yahaya A Ukwenya
Department of Surgery, Ahmadu Bello University Teaching Hospital, Zaria
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/2278-9596.122925

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Background: Management of colorectal cancer (CRC) in Nigeria is associated with such challenges as operating on locally advanced tumors. We performed a prospective observational study to assess the prevalence of surgical site infection (SSI) following CRC resection in a low resource setting. Materials and Methods: Consecutive patients, who had standard oncologic resection for CRC at Ahmadu Bello University Teaching Hospital, Zaria over a 5-year period from 2008 to 2012, were enrolled into the study. From 2010, patients with locally advanced rectal cancers were given neoadjuvant chemoradiation with concurrent 45 Gy external beam radiation over 5 weeks and fortnightly FOLFOX 4 regimen to downstage tumor followed 6 weeks later by surgery. Surgical resections were performed through open laparotomy. The outcome of interest was the development of SSI within 30 days of surgery. Patient and surgical variables were evaluated for association with SSI. Results: Of 188 patients seen with CRC, 78 (41.5%) had surgical resection and 75 were analyzed for SSI. The prevalence of SSI was 13.7% following transabdominal colectomy, 50% following abdominoperineal resection and 25.3% following overall CRC resection (P < 0.05). There was no SSI in patients whose local tumors were confined to the bowel wall, but 35.2% of patients with locally advanced tumors had SSI (P <0.05). Treatment with neoadjuvant chemoradiation, sex, body mass index, wound classification, surgical procedure duration, use of diverting stoma and perioperative blood transfusion were the significant variables (P < 0.05) for SSI. Conclusion: We observed that the prevalence of SSI in our setting is high and is possibly due to the difficulties of surgical resection of tumors most of which were locally advanced at the time of surgery among other factors.

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