Postoperative sepsis after colorectal surgery: a prospective single-center observational study and review of the literature

Postoperative sepsis represents a significant problem in colorectal surgery patients.To identify the etiology as well as the risk factors associated with the development of postoperative sepsis, based on prospective data of patients undergoing colorectal surgery at a single large-volume institution.Between November 2019 and February 2021, 141 patients underwent an elective operation for colorectal cancer at a tertiary hospital center. The following variables were recorded for each patient: age, gender, American Society of Anesthesiologists Classification (ASA class), duration of surgery, surgical approach, comorbidities (diabetes, cardiovascular disease, respiratory disease). Univariate analysis was performed using χ2 tests for categorical variables.A total of 69 males and 72 females were enrolled. Postoperative sepsis was diagnosed in 18 (12.77%) cases, with anastomotic leakage being the most frequent cause (3.55%). There was no statistically significant difference in the presence of sepsis among patients when gender, surgical approach, duration of surgery, and respiratory disease were taken into account. Sixty-nine patients were > 65 years old, with sepsis being statistically significant in this group (p = 0.034). Furthermore, patients with ASA class ≤ 2 developed postoperative sepsis less frequently than patients with advanced ASA scores (p = 0.008). Diabetes and cardiovascular disease also reach statistical significance; sepsis was more frequent in this group of patients (p = 0.013 and p = 0.009, respectively).Following colorectal cancer procedures, postoperative sepsis was significantly more common among patients over 65 years old, ASA score > 2, and also with associated comorbidities such as diabetes and cardiovascular disease.