RETRACTED ARTICLE: Colorectal Infraperitoneal Anastomosis: The Effects of Perioperative Supplemental Oxygen Administration on the Anastomotic Dehiscence

Schietroma, Mario; Carlei, Francesco; Cecilia, Emanuela Marina; Piccione, Federica; Bianchi, Zuleyka; Amicucci, Gianfranco

doi:10.1007/s11605-011-1717-1

Cited by 46 publications

(26 citation statements)

References 44 publications

(37 reference statements)

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“…30,64 The baseline risk of SSI, i.e., the incidence of SSI in patients receiving normal FIo 2 , ranged from 7 30 to 27%. 28 When data were combined, there was an average incidence of 14.1% with normal FIo 2 and of 11.4% with high FIo 2 ; RR, 0.77 (95% CI, 0.59-1.00; fig. 2A).…”

Section: Synthesis Of Resultsmentioning

confidence: 96%

“…Nine studies (5,103 patients) reported on the incidence of SSI (table 1). 4 28 Seven studies used a standardized method for SSI assessment: three considered the ASEPSIS scoring system, 4,5,58 two used the definition of the Centers for Disease Control and Prevention, 30,63 and two considered a prospectively determined scoring system. 28,66 In all trials except one, 30 90-100% of patients received prophylactic antibiotics.…”

Section: Synthesis Of Resultsmentioning

confidence: 99%

“…[4][5][6][7][27][28][29][30][55][56][57][58][59][60][61][62][63][64][65][66][67][68][69][70][71][72] Seven reports with additional data from 900 patients have not been considered for any previously published metaanalyses. [27][28][29][30]61,69,70 Two articles reporting on pulmonary outcomes 56 and PoNV, 7 respectively, were subgroup analyses of a multicenter study that reported on SSI. 5 Results of another multicenter study reporting on SSI and pulmonary outcomes 63 were reported in two further articles; one concentrated on pulmonary outcomes in obese patients 70 and the other on pulmonary outcomes in patients scheduled for laparotomy for ovarian cancer.…”

Section: Study Selectionmentioning

confidence: 99%

“…Four trials were performed exclusively in patients undergoing colorectal surgery, 4,5,28,62 and from four, data from patients undergoing colorectal surgery could be extracted. 30,63,64,66 When all colorectal surgery data were combined (n = 1,977), there was an average incidence of SSI of 19.3% with normal FIo 2 and of 15.2% with high FIo 2 ; RR, 0.78 (95% CI, 0.60-1.02; fig.…”

Section: Perioperative Medicinementioning

confidence: 99%

“…[20][21][22][23][24][25][26] A number of further relevant clinical trials studying these issues have been published recently. [27][28][29][30] The aim of our study was to update previously published meta-analyses, and to provide a comprehensive quantitative summary of the most important, potentially beneficial (decrease in the risk of SSI or PoNV) and harmful (increase in the risk of pulmonary complications) effects of intraoperative high inspired FIo 2 on surgical patients.…”

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confidence: 99%

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Effect of Intraoperative High Inspired Oxygen Fraction on Surgical Site Infection, Postoperative Nausea and Vomiting, and Pulmonary Function

et al. 2013

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Background: Intraoperative high inspired oxygen fraction (FIo 2 ) is thought to reduce the incidence of surgical site infection (SSI) and postoperative nausea and vomiting, and to promote postoperative atelectasis. Methods: The authors searched for randomized trials (till September 2012) comparing intraoperative high with normal FIo 2 in adults undergoing surgery with general anesthesia and reporting on SSI, nausea or vomiting, or pulmonary outcomes. Results: The authors included 22 trials (7,001 patients) published in 26 reports. High FIo 2 ranged from 80 to 100% (median, 80%); normal FIo 2 ranged from 30 to 40% (median, 30%). In nine trials (5,103 patients, most received prophylactic antibiotics), the incidence of SSI decreased from 14.1% with normal FIo 2 to 11.4% with high FIo 2 ; risk ratio, 0.77 (95% CI, 0.59-1.00). After colorectal surgery, the incidence of SSI decreased from 19.3 to 15.2%; risk ratio, 0.78 (95% CI, 0.60-1.02). In 11 trials (2,293 patients), the incidence of nausea decreased from 24.8% with normal FIo 2 to 19.5% with high FIo 2 ; risk ratio, 0.79 (95% CI, 0.66-0.93). In patients receiving inhalational anesthetics without prophylactic antiemetics, high FIo 2 provided a significant protective effect against both nausea and vomiting. Nine trials (3,698 patients) reported on pulmonary outcomes. The risk of atelectasis was not increased with high FIo 2 . Conclusions: Intraoperative high FIo 2 further decreases the risk of SSI in surgical patients receiving prophylactic antibiotics, has a weak beneficial effect on nausea, and does not increase the risk of postoperative atelectasis. IT has been claimed that patients undergoing surgery with general anesthesia were benefiting from a higher than normal inspired oxygen fraction (FIo 2 ).1,2 Some authors have suggested that a high FIo 2 was a simple, inexpensive, and lowrisk intervention, and that the broader use of this technique should be encouraged in patients undergoing major abdominal procedures.3 Randomized trials have reported on a reduced risk of surgical site infection (SSI) in patients who were ventilated with 80% FIo 2 during surgery. 4,5 It was also shown that patients who were ventilated with high FIo 2 intraoperatively had a reduced incidence of postoperative nausea and vomiting (PoNV). 6,7 other authors were more cautious. 8,9 Skepticism has been partly related to the fact that high FIo 2 may have deleterious What This Article Tells Us That Is New• Intraoperative high inspired oxygen fraction decreases the risk of surgical site infection in surgical patients receiving prophylactic antibiotics, has a weak beneficial effect on nausea, and does not increase the risk of postoperative atelectasis

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Section: Synthesis Of Resultsmentioning

confidence: 96%

Section: Synthesis Of Resultsmentioning

confidence: 99%

Section: Study Selectionmentioning

confidence: 99%

Section: Perioperative Medicinementioning

confidence: 99%

mentioning

confidence: 99%

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Effect of Intraoperative High Inspired Oxygen Fraction on Surgical Site Infection, Postoperative Nausea and Vomiting, and Pulmonary Function

et al. 2013

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The effects of high perioperative inspiratory oxygen fraction for adult surgical patients

Wetterslev

Meyhoff

Jørgensen

et al. 2015

Cochrane Database of Systematic Reviews

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Contemporary perioperative care strategies

Adamina

Gié

Demartines

et al. 2012

British Journal of Surgery

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Background: Historically, the preoperative and postoperative care of patients with gastrointestinal cancer was provided by surgeons. Contemporary perioperative care is a truly multidisciplinary endeavour with implications for cancer-specific outcomes.Methods: A literature review was performed querying PubMed and the Cochrane Library for articles published between 1966 to 2012 on specific perioperative interventions with the potential to improve the outcomes of surgical oncology patients. Keywords used were: fast-track, enhanced recovery, accelerated rehabilitation, multimodal and perioperative care. Specific interventions included normothermia, hyperoxygenation, surgical-site infection, skin preparation, transfusion, non-steroidal anti-inflammatory drugs, thromboembolism and antibiotic prophylaxis, laparoscopy, radiotherapy, perioperative steroids and monoclonal antibodies. Included articles had to be randomized controlled trials, prospective or nationwide series, or systematic reviews/meta-analyses, published in English, French or German.Results: Important elements of modern perioperative care that improve recovery of patients and outcomes in surgical oncology include accelerated recovery pathways, thromboembolism and antibiotic prophylaxis, hyperoxygenation, maintenance of normothermia, avoidance of blood transfusion and cautious use of non-steroidal anti-inflammatory drugs, promotion of laparoscopic surgery, chlorhexidine-alcohol skin preparation and multidisciplinary meetings to determine multimodal therapy.Conclusion: Multidisciplinary management of perioperative patient care has improved outcomes.

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RETRACTED ARTICLE: Colorectal Infraperitoneal Anastomosis: The Effects of Perioperative Supplemental Oxygen Administration on the Anastomotic Dehiscence

Abstract: Therefore, supplemental 80% FiO2 during and for 6 h after major rectal cancer surgery, reducing postoperative anastomotic dehiscence, should be considered part of ongoing quality improvement activities related to surgical care, with few risks to the patient and little associated cost.

Cited by 46 publications

References 44 publications

Effect of Intraoperative High Inspired Oxygen Fraction on Surgical Site Infection, Postoperative Nausea and Vomiting, and Pulmonary Function

Effect of Intraoperative High Inspired Oxygen Fraction on Surgical Site Infection, Postoperative Nausea and Vomiting, and Pulmonary Function

The effects of high perioperative inspiratory oxygen fraction for adult surgical patients

Contemporary perioperative care strategies

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