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Efficacy of preoperative bowel prepping with oral antibiotic combination in reducing the rate of anastomotic leakage in patients undergoing oncologic resection for colorectal cancer
13 August 2018 (online)
Anastomotic leakage (AI) following resection of colon cancer represents the most fared complication. Preoperative bowel prepping with oral antibiotics is thought tob e associated with reduced risk of AI. It is unclear whether the reduced risk of AI is primarily due to bowel cleansing or is secondary to oral antibiotics. We investigated the effective of preoperative bowel cleansing with and without oral antibiotics on the rate of AI in patients undergoing oncologic colon resection with anastomosis.
Materials and methods:
The study group included patients undergoing oncologic colorectal resection after bowel cleansing with vancomycin and metronidazol adjunct (prepping + AB) while the control group consisted of patients undergoing bowel cleansing without antibiotics (cleansing – AB). The primary outcome was the rate of AI. Secondary outcome was the rate of surgical site infection (SSI).
The study group consisted of 126 patients (cleansing + AB) while 373 patients were included in the control group (cleansing – AB). Significantly more male patients were included in the study group; 45.2% vs. 39.7%, p = 0.03. Both groups were similar with regard to age distribution and clinicopathologic findings (p > 0.05). The rate of AI was significantly higher in the control group (Cleansing – AB) compared to study group (Cleansing + AB); 9.1% vs. 4.0%, p = 0.03. There was no significant difference amongst both groups with regard to SSI; 1.6% and 2.6% in the study and control group respectively, p = 0.49.
Preoperative bowel cleansing with oral antibiotics adjunct significantly reduces the risk of AI in patients undergoing colorectal resection with anastomosis.