The role of mechanical bowel preparation and oral antibiotics for left-sided laparoscopic and open elective restorative colorectal surgery with and without faecal diversion

Background There is significant variation in the use of mechanical bowel preparation and oral antibiotics prior to left-sided elective colorectal surgery. There has been no consensus internationally. Methods This was a retrospective analysis of the 2015 American College of Surgeons National Surgical...

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Bibliographic Details
Published in:International journal of colorectal disease 2018-12, Vol.33 (12), p.1781-1791
Main Authors: Toh, James Wei Tatt, Phan, Kevin, Ctercteko, Grahame, Pathma-Nathan, Nimalan, El-Khoury, Toufic, Richardson, Arthur, Morgan, Gary, Tang, Reuben, Zeng, Mingjuan, Donovan, Susan, Chu, Daniel, Kennedy, Gregory, Hitos, Kerry
Format: Article
Language:English
Subjects:
Administration, Oral
Aged
Analysis
Anastomotic Leak - etiology
Anti-Bacterial Agents - administration & dosage
Anti-Bacterial Agents - pharmacology
Antibiotics
Cathartics - pharmacology
Colorectal surgery
Colorectal Surgery - adverse effects
Elective Surgical Procedures - adverse effects
Feces
Female
Gastroenterology
Health aspects
Hepatology
Humans
Infection
Infections
Internal Medicine
Intestine
Laparoscopic surgery
Laparoscopy
Laparoscopy - adverse effects
Logistic Models
Male
Medical societies
Medicine
Medicine & Public Health
Middle Aged
Multivariate Analysis
Original Article
Proctology
Quality control
Surgery
Surgical site infections
Surgical Wound Infection - etiology
Treatment Outcome
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Summary:Background There is significant variation in the use of mechanical bowel preparation and oral antibiotics prior to left-sided elective colorectal surgery. There has been no consensus internationally. Methods This was a retrospective analysis of the 2015 American College of Surgeons National Surgical Quality Improvement Program database. Patients were divided into four groups: those who had mechanical bowel preparation with oral antibiotics, mechanical bowel preparation alone, oral antibiotics alone and no preparation. The main outcome measures included overall, superficial, deep and organ/space surgical site infections. Secondary outcomes included anastomotic leak, ileus and rate of Clostridium difficile . Results A total of 5729 patients were included for analysis. The overall surgical site infection rate (any superficial, deep or organ/space infection) was significantly lower in the mechanical bowel preparation and oral antibiotics approach when compared to no preparation (OR = 0.46, 95% CI 0.36–0.59, P  
ISSN:0179-1958
1432-1262
DOI:10.1007/s00384-018-3166-8