Preoperative mechanical bowel preparation with oral antibiotics reduces surgical site infection after elective colorectal surgery for malignancies: results of a propensity matching analysis

Autor: Xiaofeng Yang, Ying Ruan, Hongbo Wei, Yujie Hou, Tufeng Chen, Purun Lei, Juekun Wu
Jazyk: angličtina
Rok vydání: 2020
Předmět:
Male
Fistula
Administration
Oral
0302 clinical medicine
Surgical oncology
Infusions
Intravenous
Cathartics
Incidence (epidemiology)
Cefmetazole
Middle Aged
Prognosis
lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens
Combined Modality Therapy
Neoadjuvant Therapy
Colorectal surgery
Anti-Bacterial Agents
Treatment Outcome
medicine.anatomical_structure
Oncology
Chemotherapy
Adjuvant
Elective Surgical Procedures
030220 oncology & carcinogenesis
Female
030211 gastroenterology & hepatology
Colorectal Neoplasms
Surgical site infection
medicine.medical_specialty
Colon
lcsh:Surgery
Rectum
Anastomosis
lcsh:RC254-282
Drug Administration Schedule
03 medical and health sciences
Bowel preparation
Preoperative Care
medicine
Humans
Surgical Wound Infection
Propensity Score
Aged
business.industry
Research
Postoperative complication
lcsh:RD1-811
Antibiotic Prophylaxis
Oral antibiotics
medicine.disease
Surgery
Case-Control Studies
Propensity score matching
business
Zdroj: World Journal of Surgical Oncology, Vol 18, Iss 1, Pp 1-7 (2020)
World Journal of Surgical Oncology
ISSN: 1477-7819
Popis: Background Surgical site infections (SSIs) are a major postoperative complication after colorectal surgery. Current study aims to evaluate prophylactic function of oral antibiotic (OA) intake in combination with mechanical bowel preparation (MBP) relative to MBP alone with respect to postoperative SSI incidence. Methods A retrospective analysis of eligible patients was conducted using the databases of the Gastrointestinal Surgery Centre, Third Affiliated Hospital of Sun Yat-sen University from 2011 to 2017. Data pertaining to postoperative hospital stay length, expenses, SSI incidence, anastomotic fistula incidence, and rates of other complications were extracted and compared. A propensity analysis was conducted to minimize bias associated with demographic characteristics. Subgroup analyses were performed to further explore protective effects of OA in different surgical sites. Results The combination of OAs and MBP was related to a significant decrease in the incidence of overall SSIs, superficial SSI, and hospitalization expenses. The MBP + OA modality was particularly beneficial for patients undergoing left-side colon or rectum resections, with clear prophylactic efficacy. The combination of MPB + OA did not exhibit significant prophylactic efficacy in patients undergoing right hemi-colon resection. Age, surgical duration, and application of OA were all independent factors associated with the occurrence of SSIs. Conclusion These results suggest that the combination of OA + MBP should be recommended for patients undergoing elective colorectal surgery, particularly for operations on the left side of the colon or rectum. Trial registration NCT04258098. Retrospectively registered
Databáze: OpenAIRE
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