The Effect of Preoperative Oral Antibiotics in the Prevention of Surgical Site Infection after Laparoscopic Colorectal Cancer Surgery: A Propensity Score Matching Study
| Autor: | Tomohiro Arita, Kazuma Okamoto, Hiroki Shimizu, Hisashi Ikoma, Takeshi Kubota, Masayoshi Nakanishi, Michihiro Kudou, Keita Katsurahara, Eigo Otsuji, Yoshiaki Kuriu, Jun Kiuchi, Hitoshi Fujiwara |
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| Rok vydání: | 2021 |
| Předmět: |
Laparoscopic surgery
medicine.medical_specialty Univariate analysis propensity score matching Performance status business.industry Colorectal cancer medicine.medical_treatment Hazard ratio oral antibiotics colorectal cancer RC799-869 Diseases of the digestive system. Gastroenterology surgical site infection medicine.disease laparoscopic surgery Gastroenterology Colorectal surgery Clinical Research Internal medicine Propensity score matching Medicine business Colectomy |
| Zdroj: | Journal of the Anus, Rectum and Colon Journal of the Anus, Rectum and Colon, Vol 5, Iss 3, Pp 319-326 (2021) |
| ISSN: | 2432-3853 |
| Popis: | Objectives Recent findings suggest that the combination of mechanical bowel preparation (MBP) and preoperative oral antibiotics (OA) decreases the risk of surgical site infection (SSI) in colorectal surgery; however, this remains controversial. The present study examined the efficacy of OA plus MBP in laparoscopic colorectal cancer (CRC) surgery using propensity score matching (PSM). Methods A total of 1080 patients with CRC underwent MBP followed by laparoscopic surgery between 2007 and 2019. OA was administered to all patients with CRC who underwent colectomy from 2018. PSM was performed to compare the effects of OA plus MBP (OA) versus MBP only (non-OA) on the rate of superficial SSI. Results Overall, 128 patients received OA. Significant differences were observed in age, the American Society of Anesthesiologists performance status (ASA-PS), liver disease, and preoperative serum albumin (Alb) between the OA and non-OA groups. The enrolled patients were matched using PSM into two groups based on the following factors: sex, age, body mass index, ASA-PS, diabetes mellitus, liver disease, Alb, and tumor location, which resulted in the disappearance of significant differences. A univariate analysis showed that blood loss of 100 g or more, non-OA, and preoperative chemotherapy or radiation correlated with SSI (p = 0.021, 0.010, 0.038). A multivariate analysis of these three variables identified blood loss of 100 g or more and non-OA as independent risk factors for SSI (hazard ratio (HR): 3.238, p = 0.031; HR: 2.547, p = 0.033). Conclusions The present study revealed that OA plus MBP markedly reduced SSI rate. OA with MBP needs to be adopted in laparoscopic CRC surgery. |
| Databáze: | OpenAIRE |
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