Mechanical Bowel Preparation and Oral Antibiotic Prophylaxis in Colorectal Surgery: Analysis of Evidence and Narrative Review

2018 ◽  
Vol 96 (6) ◽  
pp. 317-325
Author(s):  
Josep M. Badia ◽  
Nares Arroyo-García
Keyword(s):  
Colorectal Surgery ◽  
Antibiotic Prophylaxis ◽  
Bowel Preparation ◽  
Mechanical Bowel Preparation ◽  
Narrative Review ◽  
Oral Antibiotic ◽  
Oral Antibiotic Prophylaxis

scholarly journals Outcome of no oral antibiotic prophylaxis and bowel preparation in Crohn’s diseases surgery

2019 ◽  
Vol 131 (5-6) ◽  
pp. 113-119 ◽  
Author(s):  
Lukas Walter Unger ◽  
Stefan Riss ◽  
Stanislaus Argeny ◽  
Michael Bergmann ◽  
Thomas Bachleitner-Hofmann ◽  
...  
Keyword(s):  
Antibiotic Prophylaxis ◽  
Bowel Preparation ◽  
Oral Antibiotic ◽  
Oral Antibiotic Prophylaxis ◽  
Crohn’S Diseases

scholarly journals Another Brick in the Wall of an Ongoing Discussion– Reduction of Anastomotic Leaks after Colorectal Resection by Preoperative Mechanical Bowel Preparation in Combination with Oral and Parenteral Antibiotics?–A Clinical Retrospective Single Center Study

2021 ◽  
Vol 8 (5) ◽  
Author(s):  
Safia O ◽  
◽  
Kuebler S ◽  
Mall JW ◽  
Tallbot SR ◽  
...  
Keyword(s):  
Colorectal Surgery ◽  
Length Of Stay ◽  
Bowel Preparation ◽  
Elective Surgery ◽  
Mechanical Bowel Preparation ◽  
Oral Antibiotic ◽  
Single Center ◽  
Elective Colorectal Surgery ◽  
Single Center Study ◽  
Center Study

Background: In colorectal surgery, postoperative Anastomotic Leak (AL) is a serious complication. Besides the surgeon`s experience, bowel preparation may have an impact on AL, but the published data are still inconclusive. The purpose of this retrospective single center study was to investigate the role of preoperative Mechanical Bowel Preparation (MBP) in combination with Oral Antibiotic Bowel Preparation (OBP) and parenteral antibiotics in a certified highvolume colorectal center. Methods: In the period of January 2017 to December 2019, all colon and rectal surgeries were recorded and separated into emergency and elective surgeries. Patients in the elective surgery group were further divided into two groups: patients with Bowel Preparation (BP) and patients without BP and were evaluated concerning to AL, postoperative hospital length of stay and mortality. Results: Between 2017 to 2019, 625 patients underwent colorectal surgery. 262 patients had emergency operations and were therefore excluded from the study. 363 patients underwent colorectal elective surgery (197men, 166 women). 44.0% received Combined Bowel Preparation (CBP), 46.8% received no BP, 3.3% received OBP only, 4.1% received MBP only, and for 1.1% nothing was documented. CBP was not only associated with a reduction in the rate of AL (P=0.038) (14.1% vs. 4.4%), but also with reduction in mortality (P=0.032) (7.6% vs. 1.2%) and length of stay (P=0.016) (14 vs. 11 days). Conclusion: Our retrospective data showed a significant impact of preoperative intestinal preparation with MBP in combination with OBP and parenteral antibiotics on AL, length of stay and mortality. Therefore we strongly recommend the use of this regimen of preoperative BP in elective colorectal surgery.

Mechanical bowel preparation and antibiotic prophylaxis in colorectal surgery: use by and opinions of Spanish surgeons

2009 ◽  
Vol 11 (1) ◽  
pp. 44-48 ◽  
Author(s):  
J. V. Roig ◽  
A. García-Fadrique ◽  
J. García-Armengol ◽  
M. Bruna ◽  
C. Redondo ◽  
...  
Keyword(s):  
Colorectal Surgery ◽  
Antibiotic Prophylaxis ◽  
Bowel Preparation ◽  
Mechanical Bowel Preparation

scholarly journals Oral antibiotics prior to colorectal surgery: Do they have to be combined with mechanical bowel preparation?

2019 ◽  
Vol 40 (8) ◽  
pp. 922-927 ◽  
Author(s):  
Tessa Mulder ◽  
Jan A.J.W. Kluytmans
Keyword(s):  
Colorectal Surgery ◽  
Bowel Preparation ◽  
Observational Studies ◽  
Meta Analysis ◽  
Mechanical Bowel Preparation ◽  
Oral Antibiotic ◽  
Oral Antibiotics ◽  
Risk Infection

AbstractTo reduce the of risk infection after colorectal surgery, oral antibiotic preparation (OAP) and mechanical bowel preparation (MBP) can be applied. Whether OAP can be used without MBP is unclear. A meta-analysis of observational studies demonstrated comparable effectiveness of OAP with and without MBP regarding SSI risk.

Value of oral antibiotic prophylaxis in colorectal surgery

1995 ◽  
Vol 82 (8) ◽  
pp. 1046-1048 ◽  
Author(s):  
C. S. McArdle ◽  
C. G. Morran ◽  
L. Pettit ◽  
C. G. Gemmell ◽  
J. D. Sleigh ◽  
...  
Keyword(s):  
Colorectal Surgery ◽  
Antibiotic Prophylaxis ◽  
Oral Antibiotic ◽  
Oral Antibiotic Prophylaxis

scholarly journals How to Prevent Anastomotic Leak in Colorectal Surgery? A Systematic Review

2020 ◽  
Vol 36 (4) ◽  
pp. 213-222
Author(s):  
Mohamed Ali Chaouch ◽  
Tarek Kellil ◽  
Camillia Jeddi ◽  
Ahmed Saidani ◽  
Faouzi Chebbi ◽  
...  
Keyword(s):  
Colorectal Surgery ◽  
Bowel Preparation ◽  
Randomized Clinical Trials ◽  
Rectal Surgery ◽  
Mechanical Bowel Preparation ◽  
Cochrane Library ◽  
Colonic Surgery ◽  
Oral Antibiotic ◽  
Published Evidence ◽  
Handsewn Anastomosis

Anastomosis leakage (AL) after colorectal surgery is an embarrassing problem. It is associated with poor consequence. This review aims to summarize published evidence on prevention of AL after colorectal surgery and provide recommendations according to the Oxford Centre for Evidence-Based Medicine. We conducted bibliographic research on January 15, 2020, of PubMed, Cochrane Library, Embase, Scopus, and Google Scholar. We retained meta-analysis, reviews, and randomized clinical trials. We concluded that mechanical bowel preparation did not reduce AL. It seems that oral antibiotic or oral antibiotic with mechanical bowel preparation could reduce the risk of AL. The surgical approach did not affect the AL rate. The low ligation of the inferior mesenteric artery could reduce the AL rate. The mechanical anastomosis is superior to handsewn anastomosis only in case of right colectomies, with similar results in rectal surgery between the 2 anastomosis techniques. In the case of right colectomies, this anastomosis could be performed intracorporeally or extracorporeally with similar outcomes. The air leak test did not reduce AL. There is no interest of external drainage in colonic surgery but drains reduced the rate of AL and rate of reoperation after low anterior resection. The transanal tube reduced the rate of AL.

scholarly journals Oral Antibiotic Prophylaxis Lowers Surgical Site Infection in Elective Colorectal Surgery: Results of a Pragmatic Cohort Study in Catalonia

2021 ◽  
Vol 10 (23) ◽  
pp. 5636
Author(s):  
Josep M. Badia ◽  
Miriam Flores-Yelamos ◽  
Ana Vázquez ◽  
Nares Arroyo-García ◽  
Mireia Puig-Asensio ◽  
...  
Keyword(s):  
Cohort Study ◽  
Colorectal Surgery ◽  
Surgical Site Infection ◽  
Antibiotic Prophylaxis ◽  
Univariate Analysis ◽  
Oral Antibiotic ◽  
Site Infection ◽  
Baseline Phase ◽  
Elective Colorectal Surgery ◽  
Oral Antibiotic Prophylaxis

Background: The role of oral antibiotic prophylaxis (OAP) and mechanical bowel preparation (MBP) in the prevention of surgical site infection (SSI) after colorectal surgery is still controversial. The aim of this study was to analyze the effect of a bundle including both measures in a National Infection Surveillance Network in Catalonia. Methods: Pragmatic cohort study to assess the effect of OAP and MBP in reducing SSI rate in 65 hospitals, comparing baseline phase (BP: 2007–2015) with implementation phase (IP: 2016–2019). To compare the results, a logistic regression model was established. Results: Out of 34,421 colorectal operations, 5180 had SSIs (15.05%). Overall SSI rate decreased from 18.81% to 11.10% in BP and IP, respectively (OR 0.539, CI95 0.507–0.573, p < 0.0001). Information about bundle implementation was complete in 61.7% of cases. In a univariate analysis, OAP and MBP were independent factors in decreasing overall SSI, with OR 0.555, CI95 0.483–0.638, and OR 0.686, CI95 0.589–0.798, respectively; and similarly, organ/space SSI (O/S-SSI) (OR 0.592, CI95 0.494–0.710, and OR 0.771, CI95 0.630–0.944, respectively). However, only OAP retained its protective effect at both levels at multivariate analyses. Conclusions: oral antibiotic prophylaxis decreased the rates of SSI and O/S-SSI in a large series of elective colorectal surgery.

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