The Role of Mechanical Bowel Preparation With Non-Absorbable Oral Antibiotics in Improving Surgical Outcomes in Elective Colectomy Within a State-Wide Collaborative

2013 ◽  
Vol 179 (2) ◽  
pp. 299
Author(s):  
E.K. Kim ◽  
J. Bonn ◽  
S. DeRoo ◽  
C. Lee ◽  
I. Stein ◽  
...  
Keyword(s):  
Bowel Preparation ◽  
Surgical Outcomes ◽  
Mechanical Bowel Preparation ◽  
Oral Antibiotics ◽  
Elective Colectomy

scholarly journals The gut microbiota and colorectal surgery outcomes: facts or hype? A narrative review

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Annamaria Agnes ◽  
Caterina Puccioni ◽  
Domenico D’Ugo ◽  
Antonio Gasbarrini ◽  
Alberto Biondi ◽  
...  
Keyword(s):  
Colorectal Surgery ◽  
Gut Microbiota ◽  
Bowel Preparation ◽  
Mechanical Bowel Preparation ◽  
Current Evidence ◽  
Oral Antibiotics ◽  
Surgery Complications ◽  
Surgery Outcomes ◽  
Eras Protocol

Abstract Background The gut microbiota (GM) has been proposed as one of the main determinants of colorectal surgery complications and theorized as the “missing factor” that could explain still poorly understood complications. Herein, we investigate this theory and report the current evidence on the role of the GM in colorectal surgery. Methods We first present the findings associating the role of the GM with the physiological response to surgery. Second, the change in GM composition during and after surgery and its association with colorectal surgery complications (ileus, adhesions, surgical-site infections, anastomotic leak, and diversion colitis) are reviewed. Finally, we present the findings linking GM science to the application of the enhanced recovery after surgery (ERAS) protocol, for the use of oral antibiotics with mechanical bowel preparation and for the administration of probiotics/synbiotics. Results According to preclinical and translational evidence, the GM is capable of influencing colorectal surgery outcomes. Clinical evidence supports the application of an ERAS protocol and the preoperative administration of multistrain probiotics/synbiotics. GM manipulation with oral antibiotics with mechanical bowel preparation still has uncertain benefits in right-sided colic resection but is very promising for left-sided colic resection. Conclusions The GM may be a determinant of colorectal surgery outcomes. There is an emerging need to implement translational research on the topic. Future clinical studies should clarify the composition of preoperative and postoperative GM and the impact of the GM on different colorectal surgery complications and should assess the validity of GM-targeted measures in effectively reducing complications for all colorectal surgery locations.

scholarly journals Understanding the role of mechanical bowel preparation and oral antibiotics prior to elective colorectal surgery

2019 ◽  
Vol 4 ◽  
pp. 47-47
Author(s):  
James Wei Tatt Toh ◽  
Joris Harlaar ◽  
Angelina Di Re ◽  
Nimalan Pathmanathan ◽  
Toufic El Khoury ◽  
...  
Keyword(s):  
Colorectal Surgery ◽  
Bowel Preparation ◽  
Mechanical Bowel Preparation ◽  
Oral Antibiotics ◽  
Elective Colorectal Surgery

scholarly journals Mechanical bowel preparation and oral antibiotics versus mechanical bowel preparation only prior rectal surgery (MOBILE2): a multicentre, double-blinded, randomised controlled trial—study protocol

BMJ Open ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. e051269
Author(s):  
Laura Koskenvuo ◽  
Pipsa Lunkka ◽  
Pirita Varpe ◽  
Marja Hyöty ◽  
Reetta Satokari ◽  
...  
Keyword(s):  
Randomised Controlled Trial ◽  
Bowel Preparation ◽  
Controlled Trial ◽  
Rectal Surgery ◽  
Mechanical Bowel Preparation ◽  
Oral Antibiotic ◽  
Oral Antibiotics ◽  
Number Of Patients ◽  
Randomised Controlled ◽  
Double Blinded

IntroductionMechanical bowel preparation (MBP) prior to rectal surgery is widely used. Based on retrospective data many guidelines recommend mechanical and oral antibiotic bowel preparation (MOABP) to reduce postoperative complications and specifically surgical site infections (SSIs). The primary aim of this study is to examine whether MOABP reduces complications of rectal surgery.Methods and analysisThe MOBILE2 (Mechanical Bowel Preparation and Oral Antibiotics vs Mechanical Bowel Preparation Only Prior Rectal Surgery) trial is a multicentre, double-blinded, parallel group, superiority, randomised controlled trial comparing MOABP to MBP among patients scheduled for rectal surgery with colorectal or coloanal anastomosis. The patients randomised to the MOABP group receive 1 g neomycin and 1 g metronidazole two times on a day prior to surgery and patients randomised to the MBP group receive identical placebo. Based on power calculations, 604 patients will be enrolled in the study. The primary outcome is Comprehensive Complication Index within 30 days after surgery. Secondary outcomes are SSIs within 30 days after surgery, the number and classification of anastomosis dehiscences, the length of hospital stay, mortality within 90 days after surgery and the number of patients who received adjuvant treatment if needed. Tertiary outcomes are overall survival, disease-specific survival, recurrence-free survival and difference in quality-of-life before and 1 year after surgery. In addition, the microbiota differences in colon mucosa are analysed.Ethics and disseminationThe Ethics Committee of Helsinki University Hospital approved the study. The findings will be disseminated in peer-reviewed academic journals.Trial registration numberNCT04281667.

Factors Associated with Receipt of Oral Antibiotic Agents and Mechanical Bowel Preparation before Elective Colectomy

2021 ◽  
Author(s):  
William J. Kane ◽  
Kevin T. Lynch ◽  
Taryn E. Hassinger ◽  
Sook C. Hoang ◽  
Charles M. Friel ◽  
...  
Keyword(s):  
Bowel Preparation ◽  
Mechanical Bowel Preparation ◽  
Oral Antibiotic ◽  
Factors Associated ◽  
Elective Colectomy ◽  
Antibiotic Agents
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