Preoperative Oral Antibiotics and Surgical Site Infections in Colon Surgery Without Mechanical Bowel Preparation. A Prospective, Multicentre, Single Blinded, Randomized Trial (ORALEV Study)

2019 ◽  
Author(s):  
Eloy Espin Basany ◽  
Alejandro Solís-Peña ◽  
Esther Kreisler ◽  
Doménico Fraccalvieri ◽  
Manuel Muinelo-Lorenzo ◽  
...  
Keyword(s):  
Randomized Trial ◽  
Bowel Preparation ◽  
Mechanical Bowel Preparation ◽  
Surgical Site Infections ◽  
Colon Surgery ◽  
Oral Antibiotics

scholarly journals Are preoperative oral antibiotics effective in reducing the incidence of anastomotic leakage after Colorectal cancer surgery: Study protocol for a prospective, multicentre, randomized controlled study

2021 ◽  
Author(s):  
Rui Qi Gao ◽  
WeiDong Wang ◽  
PengFei Yu ◽  
ZhenChang Mo ◽  
DanSheng Dong ◽  
...  
Keyword(s):  
Anastomotic Leakage ◽  
Bowel Preparation ◽  
Mechanical Bowel Preparation ◽  
Surgical Site Infections ◽  
Colon Surgery ◽  
Ethics Committee ◽  
Oral Antibiotics ◽  
Colorectal Cancer Surgery ◽  
Randomized Controlled ◽  
Intestinal Preparation

Abstract Introduction The optimal preoperative preparation for elective colorectal cancer surgery has been debated in academic circles for decades. Previously, many expert teams have conducted studies on whether preoperative mechanical bowel preparation and preoperative oral antibiotics can effectively reduce the incidence of postoperative complications, such as surgical site infections and anastomotic leakage. Most of the results of these studies have suggested that preoperative mechanical bowel preparation for elective colon surgery has no significant effect on the occurrence of surgical site infections and anastomotic leakage. Methods/design This study will examine whether oral antibiotic bowel preparation (OABP) influences the incidence of anastomotic leakage after surgery in a prospective, multicentre, randomized controlled trial that will enrol 1500 patients who need colon surgery. The primary endpoint, incidence of anastomotic leakage, is based on 2.3% in the OABP ± mechanical bowel preparation (MBP) group in the study by Morris et al. The patients will be randomized (1:1) into two groups: the test group will be given antibiotics (both neomycin 1 g and metronidazole 1 g) the day before surgery, and the control group will not have any special intestinal preparation before surgery, including oral antibiotics or mechanical intestinal preparation. All study-related clinical data, such as general patient information, past medical history, laboratory examination, imaging results, and surgery details, will be recorded before surgery and during the time of hospitalization. The occurrence of postoperative fistulas, including anastomotic leakage, will be recorded as the main severe postoperative adverse event and will represent the primary endpoint. Ethics and dissemination Ethics and dissemination Ethics approval has been obtained from the Ethics Committee at the Chinese Ethics Committee of Registering Clinical Trials(ChiECRCT20200173). The results of this study will be disseminated at several research conferences and as published articles in peer-reviewed journals. Trial registration: ChiCTR2000035550. Registered on 13 Aug 2020.

scholarly journals EP.TH.965Use of Oral Antibiotics as Adjunct to Systemic Antibiotics and Mechanical Bowel Preparation for Left Sided Colorectal Surgery. It is the time to trust the best available evidence and change the practice

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Shahin Hajibandeh ◽  
Shahab Hajibandeh ◽  
Christopher Thompson ◽  
Vijay Thumbe ◽  
Andrew Torrance ◽  
...  
Keyword(s):  
Colorectal Surgery ◽  
Anastomotic Leak ◽  
Bowel Preparation ◽  
Mechanical Bowel Preparation ◽  
Surgical Site Infections ◽  
Oral Antibiotics ◽  
Intravenous Antibiotics ◽  
Clinically Significant ◽  
The Uk ◽  
Systemic Antibiotics

Abstract Aims To prospectively evaluate the clinical efficacy of oral antibiotics as an adjunct to intravenous antibiotics and mechanical bowel preparation (MBP) in patients undergoing left sided colorectal surgery. Methods All participants aged 18 years or older and of any gender undergoing an elective open or laparoscopic left sided colorectal resection for benign or malignant colorectal pathologies were considered. The intervention of interest was oral neomycin 1g every 4 hours combined with oral metronidazole 400mg every 8 hours from 24 hours before the proposed surgery. Surgical site infections (SSIs), anastomotic leak, paralytic ileus, need for intervention, and mortality were the evaluated outcome parameters. Results Forty-two consecutive patients received oral antibiotics as an adjunct to intravenous antibiotics and MBP before left sided colorectal surgery. The mean age was 58.8 ± 11.5. There were 23 males (54.8%) and 19 females (45.2%). Use of oral antibiotics was associated with SSI infection rate of 2.4% (1 patient). The rates of clinically significant and non-significant anastomotic leak were 0% and 2.9%, respectively. Moreover, postoperative ileus happened in 11.9% of patients. Furthermore, there was no mortality or need for re-intervention. Conclusions Use of oral antibiotics as an adjunct to intravenous antibiotics and MBP in patients undergoing left-sided colorectal surgery was associated with a surprisingly low rate of SSIs and no significant anastomotic leak. It is time to trust the best available evidence and incorporate the use of oral antibiotics as an adjunct to intravenous antibiotics and MBP in colorectal surgery protocols in the UK hospitals.

Mechanical Bowel Preparation or Not? Outcome of a Multicenter, Randomized Trial in Elective Open Colon Surgery

2005 ◽  
Vol 48 (8) ◽  
pp. 1509-1516 ◽  
Author(s):  
Patrick Fa-Si-Oen ◽  
Rudi Roumen ◽  
John Buitenweg ◽  
Cornelis van de Velde ◽  
Dick van Geldere ◽  
...  
Keyword(s):  
Randomized Trial ◽  
Bowel Preparation ◽  
Mechanical Bowel Preparation ◽  
Colon Surgery ◽  
Multicenter Randomized Trial

Single-blinded Randomized Trial of Mechanical Bowel Preparation for Colon Surgery with Primary Intraperitoneal Anastomosis

2008 ◽  
Vol 12 (12) ◽  
pp. 2103-2109 ◽  
Author(s):  
María Jesús Pena-Soria ◽  
Julio M. Mayol ◽  
Rocio Anula ◽  
Ana Arbeo-Escolar ◽  
Jesús A. Fernandez-Represa
Keyword(s):  
Randomized Trial ◽  
Bowel Preparation ◽  
Mechanical Bowel Preparation ◽  
Colon Surgery
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