Bowel Preparation and Oral Antibiotic Agents for Selective Decontamination in Colorectal Surgery: Current Practice, Perspectives, and Trends in Australia and New Zealand, 2019–2020

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.

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

Cirugía Española (English Edition) ◽

10.1016/j.cireng.2018.03.001 ◽

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

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A Chinese Survey of Current Practice Patterns of Preoperative Bowel Preparation in Colorectal Surgery

10.21203/rs.3.rs-625927/v1 ◽

2021 ◽

Author(s):

Hong Yu ◽

Li Xu ◽

Shuhao Liu ◽

Songcheng Yin ◽

Chunhong Hong ◽

...

Keyword(s):

Colorectal Surgery ◽

Anastomotic Leakage ◽

Bowel Preparation ◽

Current Practice ◽

Practice Patterns ◽

Postoperative Bleeding ◽

Preparation Methods ◽

Reduce Risk ◽

Preoperative Bowel Preparation ◽

Lavage Solution

Abstract Background Bowel preparation has long been considered as the standard preoperative management for colorectal surgery. However, there are still controversies about bowel preparation and the importance of bowel preparation gradually declined. The purpose of this study is to describe the current attitudes and practice patterns of preoperative bowel preparation among Chinese surgeons. Methods An online 11-question anonymous survey was randomly assigned to Chinese surgeons. The questionnaire sought information on each surgeon’s current practice of preoperative bowel preparation. Results 384 Chinese surgeons from 26 provincial administrative regions took part in this survey. The most common reason for choosing bowel preparation was preventing surgical site infection (SSI). Meanwhile, 74% Chinese surgeons believed bowel preparation could avoid anastomotic leakage. Only 34% thought that bowel preparation was considered to reduce risk of postoperative bleeding. In terms of bowel preparation methods, 57% Chinese surgeons preferred to choose laxatives alone. Regarding the choices of agents, Chinese surgeons were more likely to choose polyethylene glycol-electrolyte lavage solution (PEG-ELS). Conclusions Surgeons choose bowel preparation mostly to avoid SSI and anastomotic leakage, and they prefer using laxatives alone. Our study shows that surgeons do not have clear guidelines that can govern their clinical practice and there are still controversies about bowel preparation. Further study is required to provide strong evidences to inform clinical and policy decisions.

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Oral Antibiotic Bowel Preparation Significantly Reduces Surgical Site Infection Rates and Readmission Rates in Elective Colorectal Surgery

Annals of Surgery ◽

10.1097/sla.0000000000001125 ◽

2015 ◽

Vol 261 (6) ◽

pp. 1034-1040 ◽

Cited By ~ 120

Author(s):

Melanie S. Morris ◽

Laura A. Graham ◽

Daniel I. Chu ◽

Jamie A. Cannon ◽

Mary T. Hawn

Keyword(s):

Colorectal Surgery ◽

Surgical Site Infection ◽

Bowel Preparation ◽

Oral Antibiotic ◽

Site Infection ◽

Infection Rates ◽

Readmission Rates ◽

Elective Colorectal Surgery

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Clinical outcomes following mechanical plus oral antibiotic bowel preparation versus oral antibiotics alone in patients undergoing colorectal surgery

BJS Open ◽

10.1002/bjs5.66 ◽

2018 ◽

Vol 2 (4) ◽

pp. 238-245 ◽

Cited By ~ 10

Author(s):

S. R. Kaslow ◽

F. Gani ◽

H. N. Alshaikh ◽

J. K. Canner

Keyword(s):

Colorectal Surgery ◽

Clinical Outcomes ◽

Bowel Preparation ◽

Oral Antibiotic ◽

Oral Antibiotics

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

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2019.157 ◽

2019 ◽

Vol 40 (8) ◽

pp. 922-927 ◽

Cited By ~ 4

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.

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