Microbiological characteristics of early and late infectious complications following total pelvic exenteration due to cervical cancer recurrence—the significance of infections in long-term outcomes

Objective: We analysed microbiological results of early and late infectious complications following total pelvic exenteration (TPE) due to cervical cancer recurrence and evaluated the significance of infections in patient survival. Methods: A retrospective study was conducted on 13 out of 31 patients who had undergone TPE due to cervical cancer, from February 2013 to January 2018. Results: Early and late infections occurred in 7 (53.8%) patients and 6 (46.1%) patients, respectively. Superficial and deep surgical site infections (SSIs) were the only ones that appeared as early infections. Late infections, besides SSIs (4/13; 30.8%), also included urinary infections (2/13; 15.4%). The most frequently isolated microorganisms were Enterococcus spp. (9/28; 32.1%) and Escherichia coli (6/28; 21.4%). There was no resistance to vancomycin, teicoplanin and linezolid among Enterocccus spp. Among gram-negative rods, there was no resistance to meropenem and imipenem. We found three ESBL (extended-spectrum ß-lactamase) producers. Patients diagnosed with early deep SSIs had a shortened median overall survival (5.0 months vs. 11.5 months, P = 0.03). Patient survival was neither related to the occurrence of early superficial infections nor to late infections. Conclusions: Our results suggest that early, especially early deep, SSI may worse the prognosis of patients after TPE. The time of infection management after the operation should be especially intensified within 1 month after TPE.

Cervical cancer recurrence; Total pelvic exenteration; Post-operative infections

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