Influencing factors analysis of acute infective enteritis after colorectal surgery

[Objectives] To investigate the influencing factors of acute infective enteritis after colorectal surgery. [Methods] We retrospectively analyzed the clinical data of 60 patients who developed acute infective enteritis after colorectal surgery at Eastern Theater Command General Hospital of the Chinese People’s Liberation Army from September 2018 to September 2023. A control group of 120 patients who underwent surgery during the same period was selected by 1∶2 matching based on gender, age, and same ward, for a control study. Univariate analysis was conducted on six factors: presence of underlying diseases (with/without), preoperative intestinal obstruction (with/without), preoperative oral probiotics combined with prebiotics (intestinal microecological pre-rehabilitation) (with/without), preoperative oral vancomycin(selective intestinal decontamination) (with/without), postoperative combined use of antibiotics (with/without), and duration of postoperative acid suppressant use. Significant univariate factors were included in multivariate Logistic regression analysis to explore the influencing factors for acute infective enteritis after colorectal surgery. [Results] Acute infective enteritis occurred in 60 patients between 2 and 12 days after surgery (median: 6.1 days), with 18 cases (30%) developing septic shock complicated by multiple organ dysfunction syndrome and 6 cases (10%) resulting in death. Univariate analysis showed that preoperative intestinal obstruction (with/without), preoperative oral probiotics combined with prebiotics (with/without), preoperative oral vancomycin (with/without), and duration of postoperative acid suppressant use were factors influencing the occurrence of acute infective enteritis after colorectal surgery (P<0.05). Multivariate Logistic regression analysis revealed that preoperative intestinal obstruction (OR＝2.325, 95%CI: 1.085-4.980, P＝0.030) was an independent risk factor for acute infective enteritis after colorectal surgery, while preoperative oral probiotics combined with prebiotics(OR＝0.224, 95%CI: 0.111-0.448, P<0.001) were protective factors. [Conclusion] Preoperative maintenance of intestinal patency, oral probiotics combined with prebiotics to regulate intestinal microecology, and rational use of antibiotics and acid suppressants during the perioperative period can effectively reduce the incidence of acute infective enteritis after colorectal surgery. Early diagnosis and treatment of acute infective enteritis should also be emphasized.