scholarly journals Can mechanical bowel preparation with oral antibiotics reduce surgical site infection and anastomotic leakage rates following elective colorectal resections?

2018 ◽  
Vol 51 (1) ◽  
pp. 21
Author(s):  
Chien-Kuo Liu ◽  
Wen-Chun Sun ◽  
Hsi-Hsien Hsu ◽  
Hao-Che Liu
BMJ Open ◽  
2021 ◽  
Vol 11 (11) ◽  
pp. e057226
Author(s):  
Juliane Friedrichs ◽  
Svenja Seide ◽  
Johannes Vey ◽  
Samuel Zimmermann ◽  
Julia Hardt ◽  
...  

ObjectiveTo assess the relative contribution of intravenous antibiotic prophylaxis, mechanical bowel preparation, oral antibiotic prophylaxis, and combinations thereof towards the reduction of surgical site infection (SSI) incidence in elective colorectal resections.Methods and analysisA systematic search of randomised controlled trials comparing interventions to reduce SSI incidence will be conducted with predefined search terms in the following databases: MEDLINE, LILACS, Cochrane Central Register of Controlled Trials (CENTRAL) and the Cochrane Database of Systematic Reviews (CDSR). Additionally, several online databases will be searched for ongoing trials, and conference proceedings and reference lists of retrieved articles will be hand searched. The title–abstract screening will be partly performed by means of a semiautomated supervised machine learning approach, which will be trained on a subset of the identified titles and abstracts identified through traditional screening methods.The primary analysis will be a multicomponent network meta-analysis, as we expect to identify studies that investigate combinations of interventions (eg, mechanical bowel preparation combined with oral antibiotics) as well as studies that focus on individual components (mechanical bowel preparation or oral antibiotics). By means of a multicomponent network meta-analysis, we aim at estimating the effects of the separate components along the effects of the observed combinations. To account for between-trial heterogeneity, a random-effect approach will be combined with inverse variance weighting for estimation of the treatment effects. Associated 95% CIs will be calculated as well as the ranking for each component in the network using P scores. Results will be visualised by network graphics and forest plots of the overall pairwise effect estimates. Comparison-adjusted funnel plots will be used to assess publication bias.Ethics and disseminationEthical approval by the Ethical Committee of the Medical Faculty of the Martin-Luther-University Halle-Wittenberg (ID of approval: 2021–148). Results shall be disseminated directly to decision-makers (eg, surgeons, gastroenterologists, wound care specialists) by means of publication in peer-reviewed journals, presentation at conferences and through the media (eg, radio, TV, etc).PROSPERO registration numberCRD42021267322.


2017 ◽  
Vol 225 (4) ◽  
pp. 465-471 ◽  
Author(s):  
Kerri A. Ohman ◽  
Leping Wan ◽  
Tracey Guthrie ◽  
Bonnie Johnston ◽  
Jennifer A. Leinicke ◽  
...  

Biomedicines ◽  
2021 ◽  
Vol 9 (9) ◽  
pp. 1184
Author(s):  
Simran Grewal ◽  
J. Reinder D. Reuvers ◽  
Gabor S. A. Abis ◽  
René H. J. Otten ◽  
Geert Kazemier ◽  
...  

Background: Surgical-site infection (SSI) and anastomotic leakage (AL) are major complications following surgical resection of colorectal carcinoma (CRC). The beneficial effect of prophylactic oral antibiotics (OABs) on AL in particular is inconsistent. We investigated the impact of OABs on AL rates and on SSI. Methods: A systematic review and meta-analysis of recent RCTs and cohort studies was performed including patients undergoing elective CRC surgery, receiving OABs with or without mechanical bowel preparation (MBP). Primary outcomes were rates of SSI and AL. Secondarily, rates of SSI and AL were compared in broad-spectrum OABs and selective OABs (selective decontamination of the digestive tract (SDD)) subgroups. Results: Eight studies (seven RCTs and one cohort study) with a total of 2497 patients were included. Oral antibiotics combined with MBP was associated with a significant reduction in SSI (RR = 0.46, 95% confidence interval (CI) 0.31–0.69), I2 = 1.03%) and AL rates (RR = 0.58, 95% CI 0.37–0.91, I2 = 0.00%), compared to MBP alone. A subgroup analysis demonstrated that SDD resulted in a significant reduction in AL rates compared to broad-spectrum OABs (RR = 0.52, 95% CI 0.30 to 0.91), I2 = 0.00%). Conclusion: OABs in addition to MBP reduces SSI and AL rates in patients undergoing elective CRC surgery and, more specifically, SDD appears to be more effective compared to broad-spectrum OABs in reducing AL.


2020 ◽  
Vol 27 (03) ◽  
pp. 594-600
Author(s):  
Sabeen Adil ◽  
Faiqa Aslam ◽  
Muhammad Usman

Mechanical bowel preparation (MBP) is the cleansing technique used clean up the large gut using oral cathartic agents like polyethylene glycol, sodium phosphate, sodium Pico sulfate, and magnesium citrate. Objectives: To compare the frequency of infectious complications between mechanical bowel preparation and no preparation in elective colonic surgery. Study Design: Randomized control trial. Setting: OPD or Indoor Surgical unit 5, DHQ Hospital, Faisalabad. Period: 1st January 2017 to 31st Dec 2018. Material & Methods: Patients diagnosed of malignant tumors of colon, appendix or cecum were included in study. Group A: mechanical bowel preparation done according to standard protocols, group B no mechanical bowel preparation was done. All patients were followed regularly for 2 weeks for presence or absence of surgical site infections and anastomotic leakage. Results: In this study, surgical site infection in both groups was compared, it shows that 18.59% (n=37) in Experimental group and 9.55% (n=19) in Control group had SSI while 81.41% (n=162) in Experimental group and 90.45% (n=180) in Control group bad no SSI, p - value was calculated as 0.009 showing a significant difference. Comparison of surgical anastomotic leakage in both groups was done, it shows that 2.51% (n=5) in Experimental group and 1.51% (n=3) in Control group had anastomotic leakage, p - value was calculated as 0.47 showing insignificant difference. Conclusion: We concluded that no mechanical bowel preparation is significantly better than mechanical bowel preparation in elective colonic surgery in terms of post-operative surgical site infection.


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