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Session: ePoster: Colon and Colorectal Cancer 10 (Mon8)

EP617 - Clostridium difficile infection after surgery for rectal cancer

Monday, May 12, 2025
8:10 AM - 8:15 AM PT
Location: Monitor 3, Sails Pavilion, Upper Level

    ePoster Presenter(s)

  • Eonbin Kim

    General surgery
    Dongguk University Ilsan Hospital
    Goyang-si, Kyonggi-do, Republic of Korea

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

    View ePoster

    • Senior Author(s)

  • YK

    Young Il Kim, n/a

    Assistant professor
    Department of Surgery, Division of Colon and Rectal Surgery, University of Ulsan College of medicine, Asan Medical Center, Seoul, Republic of Korea
    Seoul, Seoul-t'ukpyolsi, Republic of Korea

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

All of the relevant financial relationships listed below have been mitigated.
Eonbin Kim: This individual has no financial relationships with ineligible companies.
Young Il Kim, n/a: This individual has no financial relationships with ineligible companies.
Purpose/Background: Clostridium difficile infection (CDI) is known to occur after gastrointestinal surgery, which can increase perioperative morbidity and mortality. Several studies have been conducted on the risk factors for the occurrence of CDI, with recent research indicating a higher prevalence in patients who have undergone ileostomy reversal surgery and its association with postoperative anastomotic leakage. This study aims to investigate the patterns of CDI occurrence in patients who receive rectal cancer surgery.

Methods/Interventions: This retrospective study reviewed medical records of rectal cancer patients who underwent low anterior resection and ultra-low anterior resection with or without ileostomy between January 2017 and December 2019. To ensure a robust comparison between the two distinct patient cohorts, we employed propensity score matching to address significant disparities in baseline characteristics and demographics. Data regarding clinical characteristics, CDI incidences before and after propensity score matching were collected. Direct real-time PCR and enzyme-linked fluorescent assay for detecting toxin A and B were used to detect CDI positivity.

Results/Outcomes: In our study of 1600 rectal cancer patients, including 848 without and 752 with ileostomy, propensity score matching reduced each group to 232, totaling 464 patients. The incidence of CDI was significantly lower at 1.1 percent (9 patients) in the non-ileostomy group versus 5.3 percent (40 patients) in the ileostomy group (p < 0.001), and this trend continued post-matching, with 0.43 percent (1 patient) versus 5.2 percent (12 patients), respectively (p = 0.001).

Conclusion/Discussion: The study reveals that rectal cancer patients without ileostomy face a significantly lower risk of CDI. This finding highlights that ileostomy, regardless of surgical method or other factors, is a key contributor to increased CDI risk.

Table 1. Clinical characteristics of study patients
There was a significant difference in the formation of ileostomy related to CDI, and adjuvant CTx and operation type also showed significant differences.

Table 2. Statistical analysis of non-matched and propensity score matched group
Many variables were found to differ significantly between the two groups. To address this, 1:1 propensity score matching was performed, with 232 patients in each group. CDI showed a significant difference between the two groups, with rates of 0.43% and 5.2%, respectively (p=0.001).