Bowel preparation for colorectal surgery

Zmora, Oded; Pikarsky, Alon J.; Wexner, Steven D.

doi:10.1007/bf02234614

Cited by 77 publications

(58 citation statements)

References 83 publications

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“…In view of this paucity of evidences to support the practice of MBP in recent studies [13,16], we planned this prospective randomized control study, over a period of 3 years, to compare the outcome of elective colorectal resective procedures following bowel preparations done mechanically in some and nonmechanically in others.…”

Section: Discussionmentioning

confidence: 99%

An Open-Label Prospective Randomized Controlled Trial of Mechanical Bowel Preparation vs Nonmechanical Bowel Preparation in Elective Colorectal Surgery: Personal Experience

Bhattacharjee

Chakraborty

2015

Indian J Surg

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Over the last two decades, preoperative mechanical bowel preparation for elective colorectal surgery has been criticized. Yet, many surgeons are still in favor of its use simply because of the belief that it achieves better clearance of the colonic fecal load. The objective of this study is to compare the outcome with regard to patient compliance and postoperative complications following elective colorectal surgery between two groups of patients, one with bowel prepared mechanically and the other by nonmechanical means. This openlabel prospective randomized controlled trial was conducted in a high-volume tertiary government referral hospital of Kolkata over a period of 3 years. It included 71 patients, divided into two groups, admitted for elective colorectal resection procedures in one surgical unit. Both methods of bowel preparation were equally well tolerated, and there was no statistically significant difference in the incidence of postoperative complications or mortality between the two groups.

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Section: Discussionmentioning

confidence: 99%

An Open-Label Prospective Randomized Controlled Trial of Mechanical Bowel Preparation vs Nonmechanical Bowel Preparation in Elective Colorectal Surgery: Personal Experience

Bhattacharjee

Chakraborty

2015

Indian J Surg

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“…), environmental factors (i.e., ventilation in operating room, sterilization of surgical instruments, etc. ), and bacterial factors are thought to be the main causes of SSI (24)(25)(26)(27)(28)(29)(30). Surgery of the colon is associated with a high incidence of SSI compared with surgery addressed to other parts of the digestive tract.…”

Section: Discussion Discussionmentioning

confidence: 99%

Perioperative antibiotic prophylaxis in laparoscopic right hemicolectomy for colon cancer: A 48-Hour regimen

Zhang¹,

Yu²,

Jin

et al. 2016

JTMR

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Purpose: The standard protocol of perioperative antibiotic use in laparoscopic colectomy for colon cancer remains to be established. Given the ever-increasing number of antibiotic options available, as well as the growing problem of antibiotic resistance, there is a need for research on this important topic. Methods: We retrospectively reviewed the clinical data of 45 patients receiving laparoscopic right hemicolectomy for colon cancer to investigate the occurrence of perioperative infections following laparoscopic surgery. This study included 45 cases receiving laparoscopic right hemicolectomy from January 2013 to December 2014. A 48-hour treatment of antibiotic prophylaxis was used. results: The incidence of incisional surgical site infection (SSI), organ/space SSI, and remote infection was retrospectively investigated. Incisional SSI occurred in 1 (2.3%) patient. Organ/space SSI occurred in 1 (2.3%) patient. No remote infection occurred. conclusions: The incidence of incisional SSI and organ/space SSI was low using a 48-hour treatment of antibiotic prophylaxis after laparoscopic right hemicolectomy for colon cancer. Therefore, the 48-hour protocol of prophylactic antibiotic treatment seems to be adequate for preventing perioperative infections in laparoscopic right hemicolectomy.

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“…It was pursued against the background that there were no national standard guidelines, yet many studies [1,99] had shown that prophylactic antibiotics are essential for patients undergoing elective colorectal surgery [1,99,104,105]. On top of this, single-dose cephalosporin use, without metronidazole, had not been proved to be an ideal prophylactic for patients undergoing colorectal surgery.…”

Section: Japanmentioning

confidence: 99%

Antibiotic Prophylaxis in Colorectal Surgery: Evolving Trends

Ongom¹

2013

J Mol Pharm Org Process Res

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Surgical antibiotic prophylaxis (SAP) is not a method of tissue sterilization, but a precisely timed measure to decrease the microbial load of intraoperative contamination to a level that does not overwhelm the host immune defence. It also does not refer to prevention of Surgical Site Infections (SSIs) following postoperative contamination. The scope of SAP is oriented around elective operations in which skin incisions are closed in the operation room [1]. In light of this, the indications are basically clean and clean-contaminated elective surgical procedures. Recommendations issued in clinical practice guidelines likewise, apply to elective surgery. The World Health Organization (WHO) Guidelines for Safe Surgery has one of its objectives as the prevention of SSIs, through the use of SAP and decontamination of the gastrointestinal tract [2].SSIs are the most common complication following surgery. Patients undergoing clean-contaminated procedures have incidences of 11% for colonic resections [3], and 3-27% for rectal procedures [4]. Careful follow up of patients in clinical trials reveals rates that are considerably higher [5]. Other septic complications, like enterocutaneous fistulae, complicated intra-abdominal infections, and septicemia, are serious but are much less common. Infectious complication rates range from 30% to 60% without SAP [6], and are <10% with it.These infections cause delayed wound healing and treatment, time lost from work and, occasionally, death. For health-care institutions, they are a major contributor to increased costs owing to longer hospital stays, readmissions and additional use of antibiotics that can lead to bacterial antibiotic-resistance. They fit the description of being a major player in patient injury, mortality, and health care costs. Patients who experience SSIs are up to 60% more likely to spend time in the Intensive Care Unit (ICU), 5 times more likely to be readmitted to hospital and twice as likely to die compared with patients without a SSI [7]. Meta-analyses demonstrate that antibiotic prophylaxis is the most Antibiotic Prophylaxis in Colorectal Surgery: Evolving Trends AbstractIntroduction: Surgical antibiotic prophylaxis has become standard practice for patients undergoing colorectal surgery. This clinical practice has changed greatly over the last three decades, and it is currently accepted worldwide. It is phenomenal in minimizing postoperative wound infection in elective surgery. Clinical practice guidelines have been developed to herald this. However, the practice is yet to be established in some regions, particularly lowincome countries. A review of the evolution of the practice is necessary.Clinical Overview: Being a clean-contaminated procedure, colorectal surgery is a typical indication for antibiotic prophylaxis. The antibiotic for use is chosen on the basis of -its activity against endogenous flora likely to be encountered, its toxicity, and its cost, in that order. Controversy persists concerning the route of administration (oral, intravenous, or both),...

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Bowel preparation for colorectal surgery

Cited by 77 publications

References 83 publications

An Open-Label Prospective Randomized Controlled Trial of Mechanical Bowel Preparation vs Nonmechanical Bowel Preparation in Elective Colorectal Surgery: Personal Experience

An Open-Label Prospective Randomized Controlled Trial of Mechanical Bowel Preparation vs Nonmechanical Bowel Preparation in Elective Colorectal Surgery: Personal Experience

Perioperative antibiotic prophylaxis in laparoscopic right hemicolectomy for colon cancer: A 48-Hour regimen

Antibiotic Prophylaxis in Colorectal Surgery: Evolving Trends

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