The role of mechanical bowel preparation and oral antibiotics for left-sided laparoscopic and open elective restorative colorectal surgery with and without faecal diversion

International Journal of Colorectal Disease
James Wei Tatt TohKerry Hitos

Abstract

There is significant variation in the use of mechanical bowel preparation and oral antibiotics prior to left-sided elective colorectal surgery. There has been no consensus internationally. This was a retrospective analysis of the 2015 American College of Surgeons National Surgical Quality Improvement Program database. Patients were divided into four groups: those who had mechanical bowel preparation with oral antibiotics, mechanical bowel preparation alone, oral antibiotics alone and no preparation. The main outcome measures included overall, superficial, deep and organ/space surgical site infections. Secondary outcomes included anastomotic leak, ileus and rate of Clostridium difficile. A total of 5729 patients were included for analysis. The overall surgical site infection rate (any superficial, deep or organ/space infection) was significantly lower in the mechanical bowel preparation and oral antibiotics approach when compared to no preparation (OR = 0.46, 95% CI 0.36-0.59, P < 0.0001). On multivariable logistic regression analysis, mechanical bowel preparation with oral antibiotics maintained a lower risk of overall surgical site infections. MBP and OAB also had a protective effect on anastomotic leak in both the laparoscopi...Continue Reading

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Citations

Feb 16, 2020·Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland·S E DuffC J Walsh
Jul 1, 2020·Journal of Perioperative Practice·Sharon D BaoasGokhan Ozuner
Mar 20, 2020·Langenbeck's Archives of Surgery·Andreas D RinkAlexis Ulrich
Aug 5, 2020·International Journal of Colorectal Disease·Zhaohui XuXin Chen
Jun 15, 2019·Infection Control and Hospital Epidemiology : the Official Journal of the Society of Hospital Epidemiologists of America·Tessa Mulder, Jan A J W Kluytmans
Aug 3, 2020·Archives of Gynecology and Obstetrics·Michail DiakosavvasAlexandros Rodolakis

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