The use of rifaximin in pre-operative period of patients with tumors of
the gastrointestinal tract – a retrospective study (2013-2016)

ntroduction: One of the most important goals of preparing a patient for elective gastrointestinal cancer surgery is prevention of postoperative complications. The literature gives many ways to prepare for surgery, but only a few suggests that pre-operative use of rifaximin provides benefits in the form of fewer perioperative complications and reduces the severity of pain during this period. O bjective: The presented project is a retrospective analysis of the effectiveness of rifaximin in the prevention of perioperative complications in patients treated in the Unit of General Surgery with the Orthopedic and Urology in the Hospital of the Ministry of the Interior and Administration in Lublin, and a review of international literature in this subject. Materials and methods: A retrospective analysis of the results of pre-operative use of rifaximin was performed in 181 patients scheduled for rectal and colorectal cancer between 2013 and 2016 in the General Surgery Unit with the Orthopedic and Urology in the Hospital of the Ministry of Interior and Administration in Lublin. Patients undergoing urgent surgery were excluded from the study. Patients were divided into 2 groups. The first group of 139 patients – patients operated on for rectal and colorectal cancer in 2013 until 2015, in whom rifaximine was not used in the preoperative period. The second group is 42 patients, operated on in 2016, in which the rifaximin was used in the pre-operative period at a dose of 2x2 tablets (400 mg) per day, 12-hour interval, for 7 days before the planned operation. Additionally, a probiotic was administered for 7 days. Drugs were ordained at the Oncological Outpatient Clinic as part of the pre-hospitalization check. R esults: The use of rifaximin in the preoperative period in patients with colorectal cancer had an effect on shortening the time of post-operative hospitalization and reduced post-surgical pain in comparison with the control group. The analysis of the cynumber and intensity of surgical complications in both groups did not differ. C onclusions: Large studies on the influence of rifaximin on the development of colorectal cancer have not been published so far. Only single reports suggest that its use has a positive effect on the perioperative period of patients treated for colorectal cancer including rectum and our retrospective analysis confirms these observations.

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Parental Presence during Induction of Anesthesia versus Sedative Premedication

Anesthesiology ◽

10.1097/00000542-199811000-00015 ◽

1998 ◽

Vol 89 (5) ◽

pp. 1147-1156 ◽

Cited By ~ 203

Author(s):

Zeev N. Kain ◽

Linda C. Mayes ◽

Shu-Ming Wang ◽

Lisa A. Caramico ◽

Maura B. Hofstadter

Keyword(s):

Perioperative Period ◽

Control Group ◽

Parental Anxiety ◽

Preoperative Period ◽

Control Groups ◽

Behavioral Measures ◽

Parental Presence ◽

Midazolam Group ◽

Oral Midazolam ◽

Post Hoc

Background Both midazolam and parental presence during induction of anesthesia are routinely used to treat preoperative anxiety in children. The purpose of this investigation was to determine which of these two interventions is more effective. Methods Anxiety of the child during the perioperative period was the primary end point. Secondary end points included anxiety of the parent and compliance of the child during induction. Children (n = 88) were randomly assigned to one of three groups: (1) 0.5 mg/kg oral midazolam; (2) parental presence during induction of anesthesia; or (3) control (no parental presence or premedication). Using multiple behavioral measures of anxiety, the effect of the intervention on the children and their parents was assessed. Results Observed anxiety in the holding area (T1), entrance to the operating room (T2), and introduction of the anesthesia mask (T3) differed significantly among the three groups (P = 0.032). Post hoc analysis indicated that children in the midazolam group exhibited significantly less anxiety compared with the children in the parental-presence group or control group (P = 0.0171). Similarly, parental anxiety scores after separation were significantly less in the midazolam group compared with the parental-presence or control groups (P = 0.048). The percentage of inductions in which compliance of the child was poor was significantly greater in the control group compared with the parental-presence and midazolam groups (25% vs. 17% vs. 0%, P = 0.013). Conclusions Under the conditions of this study, oral midazolam is more effective than either parental presence or no intervention for managing a child's and parent's anxiety during the preoperative period.

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The state of platelet-vascular hemostasis in the preoperative period in the case of preservation with concomitant ischemia human disease

Problems of Uninterrupted Medical Training and Science ◽

10.31071/promedosvity2020.04.078 ◽

2020 ◽

Vol 40 (4) ◽

pp. 78-81

Author(s):

Ye. O. Trofymovych ◽

Keyword(s):

Coronary Heart Disease ◽

Heart Disease ◽

Platelet Aggregation ◽

Population Aging ◽

Perioperative Complications ◽

Perioperative Period ◽

Preoperative Period ◽

Clear Trend ◽

Primary Hemostasis ◽

Age Related

Recently, there has been a clear trend towards progressive population aging of the population both in Ukraine and in the world, which leads to an increase in the number of elderly and senile people. Many of them undergo surgery for various chronic cancers, which is often dangerous due to concomitant age-related pathology, reduced functional reserves and a high risk of perioperative complications. Among the variety of age-related diseases, the leading place is occupied by cardiovascular, first of all, coronary heart disease, which is the main part of concomitant pathology in patients preparing for surgery and is considered as a significant modified risk factor for perioperative complications. We conducted a study of hemocoagulation in 52 patients with concomitant coronary heart disease who were scheduled for abdominal surgery. The rates of platelet aggregation and coagulogram in the preoperative period were evaluated. Types of disorders of platelet-vascular hemostasis, which were associated with the age of patients and the duration of coronary heart disease, were identified. Patients with a longer duration of coronary heart disease and older age have a tendency to disturb primary hemostasis in the form of hyperaggression (18 patients; 35 %) or hypoaggregation (13 patients; 25 %). The coagulogram study revealed compensatory changes associated with impaired platelet aggregation. The importance of complex monitoring of the hemostasis system in these patients in the perioperative period for differentiated correction of established disorders is pointed out.

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Immunonutrition Changes Inflammatory Response in Colorectal Cancer: Results from a Pilot Randomized Clinical Trial

Cancers ◽

10.3390/cancers13061444 ◽

2021 ◽

Vol 13 (6) ◽

pp. 1444

Author(s):

Mateusz Wierdak ◽

Marcin Surmiak ◽

Katarzyna Milian-Ciesielska ◽

Mateusz Rubinkiewicz ◽

Anna Rzepa ◽

...

Keyword(s):

Colorectal Cancer ◽

Nutritional Support ◽

Tumor Tissue ◽

Control Group ◽

Preoperative Period ◽

First Choice ◽

Tnf Α ◽

Oral Nutritional Supplements ◽

Immune Group ◽

The Impact

Introduction: Surgery is the first choice of treatment for colorectal cancer. Nutritional support in the form of oral nutritional supplements (ONSs) in the preoperative period is widely accepted for reducing the incidence of perioperative complications, and immunonutrition is generally recommended. However, there is little clinical data regarding the impact of such treatment on tumor biology. Material and Methods: In this study, tumor tissue and blood samples were collected from 26 patients during preoperative colonoscopy at the time of clinical diagnosis (sample A). Group 1 received standard ONSs (3× Nutricia Nutridrink Protein per day) for 2 weeks before surgery. In group 2, immune ONSs (2× Nestle Impact Oral) were administered for the same duration. Tumor tissue (sample B) was then retrieved from the tumor after resection. Changes in the expression levels of inflammatory cytokines (TNF-α, interleukin 8 or chemokine (C-X-C motif) ligand (CXCL8), stromal cell-derived factor 1 (SDF1a), chemokine (C-X-C motif) ligand 6 (CXCL6), chemokine (C-X-C motif) ligand (CXCL2), myeloperoxidase (MPO), and CXCL1) were assessed during the perioperative course. Results: TNF-α expression differed after intervention between the two groups (immune group 31.63 ± 13.28; control group 21.54 ± 6.84; p = 0.049) and prior to and after intervention in the control group (prior to intervention 35.68 ± 24.41; after intervention 21.54 ± 6.84; p = 0.038). Changes in CXCL8 expression in the control group occurred prior to and after intervention (prior to intervention 2975.93 ± 1484.04; after intervention 1584.85 ± 1659.84; p = 0.041). CXCL1 expression was increased in the immune group and decreased in the control group (immune group 2698.27 (1538.14–5124.70); control group 953.75 (457.85–1534.60); p = 0.032). In both groups, a decrease in superficial neutrophil infiltration was observed, but this was only statistically significant in the immune group. There was no impact of the observed differences between the two groups on surgical outcomes (morbidity, length of stay, readmissions). Conclusions: Immunonutrition in the preoperative period compared with standard nutritional support may influence inflammatory cytokine expression and leukocyte infiltration in patients with colorectal cancer.

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To Evaluate the Effectiveness of Plasmapheresis as a Method for the Graft Disease Prevention in Patients with Keratoplasty

Ophthalmology in Russia ◽

10.18008/1816-5095-2021-4-946-954 ◽

2021 ◽

Vol 18 (4) ◽

pp. 946-954

Author(s):

S. N. Sakhnov ◽

V. V. Myasnikova ◽

K. I. Melkonyan ◽

S. V. Kravchenko

Keyword(s):

Penetrating Keratoplasty ◽

Comparison Group ◽

Corneal Transplantation ◽

Perioperative Period ◽

Main Group ◽

Surgical Pathology ◽

Control Group ◽

Preoperative Period ◽

Rejection Reaction ◽

Graft Disease

Purpose: to evaluate the effectiveness of plasmapheresis as a method for preventing and treating the graft rejection reaction in corneal transplantation.Patients and methods. The study involved patients with surgical pathology of the cornea, who underwent a prophylactic course of plasmapheresis procedures and underwent penetrating keratoplasty (Main group); and patients with surgical pathology of the cornea who underwent penetrating keratoplasty, but did not undergo plasmapheresis (Comparison group), whose data were analyzed retrospectively. The control group consisted of conditionally healthy individuals of both genders. Subgroups of patients with high and low risk keratoplasty were also identified within the Main group and the Comparison group.Results. Patients with keratoplasty who received a course of therapeutic plasmapheresis in the perioperative period demonstrated a statistically significant increase in the number of cases of a decrease in the level of C-reactive protein and a statistically significant decrease in the median values of the mean stimulated cytochemical index and the mobilization coefficient. Depending on the risk group for keratoplasty, the patients showed different dynamics of the levels of the studied interleukins after the course of plasmapheresis and keratoplasty. In patients of the Comparison group who did not receive a course of plasmapheresis in the preoperative period, over a period of 1.3 years, 22 cases (24 %) developed graft disease, while patients of both subgroups of the Main group who received a course of therapeutic plasmapheresis in the preoperative period, didn’t demonstrate any cases of graft disease. In patients of the Comparison group (in total for two subgroups), the maximum number of cases of graft disease (n = 24) was observed in the first 500 days after surgery. At the same time, the patients of the Main group who underwent plasmapheresis had the best graft survival rates: during the observation period, there were no cases of graft disease (in both subgroups).Conclusion: the obtained data indicate the ability of plasmapheresis, performed in the perioperative period, to prevent the development of graft disease in patients with keratoplasty.

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Effects of Multimodal Analgesic Protocol, with Buprenorphine and Meloxicam, on Mice Well-Being: A Dose Finding Study

Animals ◽

10.3390/ani11123420 ◽

2021 ◽

Vol 11 (12) ◽

pp. 3420

Author(s):

Kayo Furumoto ◽

Kumi Ogita ◽

Tomomi Kamisaka ◽

Asami Kawasumi ◽

Koushi Takata ◽

...

Keyword(s):

Tap Water ◽

Perioperative Period ◽

Well Being ◽

Postoperative Recovery ◽

Dose Finding ◽

Control Group ◽

Negative Effects ◽

Surgical Pain ◽

Negative Side Effects ◽

Weight Decrease

The anesthetic or analgesic agent of choice, route and frequency of anesthetic or analgesic administration, and stressors induce distress during the perioperative period. We evaluated a multimodal analgesic protocol using buprenorphine and meloxicam on the well-being of mice. Twenty-four Slc:ICR male mice were divided into control, anesthesia + analgesia, and surgery + anesthesia + analgesia groups. Tap water (orally: PO) and water for injection (subcutaneous: SC) were administered to the control group. Buprenorphine was administered twice (SC, 0.1 mg/kg/8 h) and meloxicam was administered thrice (PO, 5 mg/kg/24 h) to the anesthesia + analgesia and surgery + anesthesia + analgesia groups. The mice were subjected to laparotomy and assessed for several parameters. Even in absence of surgical pain, the anesthesia + analgesia group presented the same negative effects as the surgery + anesthesia + analgesia group. This multimodal analgesic protocol for mice was expected to have an analgesic effect on pain associated with laparotomy but was not sufficient to prevent food intake and weight decrease. This does not negate the need to administer analgesics, but suggests the need to focus on and care not only about the approach to relieve pain associated with surgery, but also other types of distresses to minimize negative side effects that may interfere with postoperative recovery in mice.

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Application of Multi-team Blood Glucose Management Model in Perioperative Period of General Surgery Patients

Journal of Clinical and Nursing Research ◽

10.26689/jcnr.v4i2.1103 ◽

2020 ◽

Vol 4 (2) ◽

Author(s):

Weirong Li ◽

Yan Zhou ◽

Xiaohua Lu ◽

Yan Liu ◽

Minpin Deng ◽

...

Keyword(s):

Blood Glucose ◽

Blood Sugar ◽

General Surgery ◽

Blood Sugar Level ◽

Intervention Group ◽

Perioperative Period ◽

Management Model ◽

Control Group ◽

Team Cooperation ◽

Glucose Management

Objective. In order to explore the application effect of blood glucose management mode of multi-team cooperation in perioperative period of general surgery patients. Methods. The perioperative blood glucose control of 94 patients undergoing surgical treatment in general surgery from January 2016 to March 2019 was reviewed by Non-synchronous. According to the perioperative blood glucose management model of multi-team cooperation, the patients were divided into intervention group and control group. From January 2016 to January 2018, 64 patients who did not implemented the multi-team blood glucose management model were the control group and from February 2018 to March 2019, 30 patients who implemented the multi-team blood glucose management model were the intervention group, compared with two group about the differences in perioperative blood glucose. Results. It is no statistically significant about two group in highest and lowest blood sugar levels under fasting stats; during the fluid diet the blood sugar level of the intervention group was lower than control group(P<0.05),and when the patients was in the semi-fluid or food-feeding period, the highest and lowest blood sugar level is that the intervention group was lower than control group(P<0.05). The time of the blood sugar reaching the standard, the coincidence of complications rate and average hospitalization days in the intervention group were particularly lower than control group(P<0.05). Conclusion. If we adopt multi-team blood glucose management model can better control the perioperative blood glucose of patients undergoing general sugar.

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Study on Prevention and Nursing of Perioperative Infection of Obstetrics and Gynecology

Journal of Nursing ◽

10.18686/jn.v1i1.1 ◽

2012 ◽

Vol 1 ◽

pp. 1 ◽

Cited By ~ 1

Author(s):

Meng Su

Keyword(s):

Retrospective Analysis ◽

Infection Prevention ◽

Perioperative Period ◽

Occurrence Rate ◽

Obstetrics And Gynecology ◽

Control Group ◽

Observation Group ◽

Depth Analysis ◽

And Control

Objective: mainly to make an in-depth analysis on the prevention and nursing of perioperative infection of obstetrics and gynecology. Method: A retrospective analysis was made on 70 patients of obstetrics and gynecology, who were randomly classified into observation group and control group. The patients of control group were routinely nursed; the patients of observation were nursed on the basis of infection prevention, finally, the nursing effects of both groups were analyzed. Results: Infection can be effectively prevented by reasonably and preoperatively using antibiotics, however, attention should be paid to the using principle of antibiotics, only in this way, can the occurrence rate of infection be reduced. Conclusion: Enhancing the effective and characteristic nursing on the patients can reduce their infection ratio and occurrence rate of complication during the perioperative period of obstetrics and gynecology, and improve the patients’ recovery.

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PREOPERATIVE CORRECTION OF SYMPTOMS OF ENDOGENOUS INTOXICATION AND VIOLATIONS OF THE OXYGEN STATUS IN PATIENTS WITH COLORECTAL CANCER

Bulletin physiology and pathology of respiration ◽

10.12737/article_5b9855e0cfa681.94615981 ◽

2018 ◽

Vol 1 (69) ◽

pp. 88-92

Author(s):

Валерий Яновой ◽

Valeriy Yanovoy ◽

Сергей Ходус ◽

Sergey Hodus ◽

Е Дегтярев ◽

...

Keyword(s):

Colorectal Cancer ◽

Hematological Parameters ◽

Preoperative Period ◽

Preoperative Preparation ◽

Integral Index ◽

Respiratory Disorders ◽

Endogenous Intoxication ◽

Positive Effect ◽

Oxygen Status ◽

Tissue Oxygen Consumption

The purpose of the study is to propose a method of preoperative correction of the symptoms of endogenous intoxication syndrome and associated respiratory disorders in patients with colorectal cancer. The study involved 68 patients having a surgery for colorectal cancer of different localization, with an increased leukocyte index of intoxication by V.K.Ostrovsky in preoperative period. The first group patients (37 subjects) in the preoperative preparation program took Cytoflavin® according to the developed scheme. The second group patients (31 subjects) had a standard preoperative preparation. As result of the research, there was revealed a positive effect of the proposed method of preoperative preparation on hematological parameters of endogenous intoxication (decrease in values of the parameters of Calf-Caliph, Ostrovsky and integral index of intoxication) and parameters of oxygen status, which changes indicated a decrease in tissue hypoxia (decrease in tissue oxygen consumption). The positive effect of the proposed method of preoperative preparation was observed in the postoperative period (reduced severity of respiratory disorders and hematological symptoms of endogenous intoxication).

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PERIOPERATION CHANGES COLON AND RECTUM MICROBIOCINOSIS WITH COLORECTAL PATIENTS

Problems in oncology ◽

10.37469/0507-3758-2019-65-4-516-523 ◽

2019 ◽

Vol 65 (4) ◽

pp. 516-523

Author(s):

Aleksandr Zakharenko ◽

Mikhail Belyaev ◽

Oleg Ten ◽

Anton Trushin ◽

Vitaliy Rybalchenko ◽

...

Keyword(s):

Colorectal Cancer ◽

Diagnostic Algorithm ◽

Perioperative Period ◽

Main Group ◽

Long Term Results ◽

Control Group ◽

Colon And Rectum ◽

Colorectal Cancer Patients ◽

Stool Analysis

Most colorectal cancer patients prove to have dysbiosis of varying severity. Perioperative period contributes to the progression of the microbiocenosis disorders. It has been proven that a large role in the development of postoperative complications is played by the state of the colon microflora. Materials. 211 colorectal cancer patient’s (T1-4N0-2M0) colon microflora was studied by PCR. Surgeries were performed laparoscopically. In the main group, developed diagnostic algorithm was used, in which initial colon flora was studied with dysbiosis progression risk determination by developed logistic regression model and perioperative correction of revealed disorders. Standards of dysbiosis treatment were used. Results. 100% patients in control group proved to have dysbiosis of varying severity: 1 grade - 27,4% (n=14), 2 grade - 37,3% (n=19), 3 grade - 31,4% (n=16), 4 grade - 3,9% (n=2). Dysbiosis progression was observed in postoperative period: 1 grade - 7,8% (n=4), 2 grade - 51,0% (n=26), 3 grade - 29,4% (n=15), 4 grade - 11,8% (n=6). The same preoperative results were registered in main group. However, after perioperative correction there was 12,5% (n=6) 3 grade and no registered 4 grade patients. Long-term results were better in the main group than in the control group. Adverse events were significantly higher in the control group against the main group (15,7% (n=8) and 4,2% (n=2) respectively). Discussion. We recommend preoperative stool analysis with PCR for colon microflora determination in order to further dysbiosis correction and treatment long-term results assessment.

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Impact of a Geriatric Intervention to Improve Screening and Management of Undernutrition in Older Patients Undergoing Surgery for Colorectal Cancer: Results of the ANC Stepped-Wedge Trial

Nutrients ◽

10.3390/nu13072347 ◽

2021 ◽

Vol 13 (7) ◽

pp. 2347

Author(s):

Thomas Gilbert ◽

Lorraine Bernard ◽

Marine Alexandre ◽

Sylvie Bin-Dorel ◽

Laurent Villeneuve ◽

...

Keyword(s):

Colorectal Cancer ◽

Older Patients ◽

Current Practice ◽

Randomized Study ◽

Intervention Group ◽

Perioperative Period ◽

Control Group ◽

Nutritional Management ◽

Stepped Wedge ◽

Oral Nutritional Supplements

Almost two in three patients who are aged 75 years and older and scheduled for surgery for colorectal cancer (CRC) are undernourished. Despite evidence that perioperative nutritional management can improve patients outcomes, international guidelines are still insufficiently applied in current practice. In this stepped-wedge cluster-randomized study of five surgical hospitals, we included 147 patients aged 70 years or older with scheduled abdominal surgery for CRC between October 2013 and December 2016. In the intervention condition, an outreach team comprising a geriatrician and a dietician visited patients and staff in surgical wards to assist with the correct application of guidelines. Evaluation, diagnosis, and prescription (according to nutritional status) were considered appropriate and strictly consistent with guidelines in 39.2% of patients in the intervention group compared to only 1.4% in the control group (p = 0.0002). Prescription of oral nutritional supplements during the perioperative period was significantly improved (41.9% vs. 4.1%; p < 0.0001). However, there were no benefits of the intervention on surgical complications or adverse events. A possible benefit of hospital stay reduction will need to be confirmed in further studies. This study highlights the importance of the implementation of quality improvement interventions into current practice for the perioperative nutritional management of older patients with CRC.

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