Randomized clinical trial of selective decontamination of the digestive tract in elective colorectal cancer surgery (SELECT trial)

The British Journal of Surgery
G S A AbisSELECT trial study group

Abstract

Infectious complications and anastomotic leakage affect approximately 30 per cent of patients after colorectal cancer surgery. The aim of this multicentre randomized trial was to investigate whether selective decontamination of the digestive tract (SDD) reduces these complications of elective colorectal cancer surgery. The effectiveness of SDD was evaluated in a multicentre, open-label RCT in six centres in the Netherlands. Patients with colorectal cancer scheduled for elective curative surgery with a primary anastomosis were eligible. Oral colistin, tobramycin and amphotericin B were administered to patients in the SDD group to decontaminate the digestive tract. Both treatment and control group received intravenous cefazolin and metronidazole for perioperative prophylaxis. Mechanical bowel preparation was given for left-sided colectomies, sigmoid and anterior resections. Anastomotic leakage was the primary outcome; infectious complications and mortality were secondary outcomes. The outcomes for 228 patients randomized to the SDD group and 227 randomized to the control group were analysed. The trial was stopped after interim analysis demonstrated that superiority was no longer attainable. Effective SDD was confirmed by interspa...Continue Reading

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Citations

Dec 25, 2019·The British Journal of Surgery·J C Alverdy, N Hyman
Dec 13, 2019·Der Chirurg; Zeitschrift für alle Gebiete der operativen Medizen·S Flemming, C-T Germer
Feb 16, 2020·Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland·S E DuffC J Walsh
Apr 5, 2020·The British Journal of Surgery·S E van OostendorpJ B Tuynman
Jun 2, 2020·Expert Review of Gastroenterology & Hepatology·Marie-Caroline BlancLaura Beyer-Berjot
Jan 21, 2021·Der Chirurg; Zeitschrift für alle Gebiete der operativen Medizen·Steffen SeyfriedChristoph Reißfelder
Feb 14, 2021·BMC Surgery·Annamaria AgnesRoberto Persiani
Feb 20, 2021·International Journal of Colorectal Disease·Ulrich WirthJulia Gumpp
Oct 12, 2019·Visceral Medicine·Andreas BognerJohannes Fritzmann

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