Does Intra-Abdominal Infection after Curative Gastrectomy Affect Patients' Long-Term Prognosis? A Multi-Center Study Based on a Large Sample Size.

BACKGROUND: The objective of the study was to investigate the effects of intra-abdominal infection after curative gastrectomy on the prognosis of patients.

PATIENTS AND METHODS: Data were collected for enrolled patients who underwent curative gastrectomy in two centers; the relationship between intra-abdominal infection and prognosis was analyzed.

RESULTS: Of the 5,721 patients in the entire group, intra-abdominal infection occurred in 202 (3.5%) patients. Co-morbidities and duration of surgical procedures ≥240 minutes represented the independent risk factors for intra-abdominal infection. The overall five-year survival of patients with and without intra-abdominal infection was 60.2% and 64.3%, respectively (p = 0.041). After propensity score matching, the five-year overall survival between the two groups was not significantly different (p = 0.909). T staging, N staging, American Society of Anesthesiologists score, and age were independent prognostic factors for the overall survival of patients who underwent curative gastrectomy. The meta-analysis of the random effects model showed that there were no significant differences in the five-year overall survival between patients with and without intra-abdominal infection.

CONCLUSIONS: The development of intra-abdominal infection after curative gastrectomy is associated closely with co-morbidities and longer operation time, whereas intra-abdominal infection does not lead to reduced long-term survival of patients.