Estudio comparativo en pacientes sometidos a cirugía colorrectal con preparación mecánica exclusiva y preparación mecánica con antibióticos orales
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Archivos
Fecha
2022
Profesor/a Guía
Facultad/escuela
Idioma
es
Título de la revista
ISSN de la revista
Título del volumen
Editor
Sociedad de Cirujanos de Chile
Nombre de Curso
Licencia CC
Attribution 4.0 International
CC BY 4.0
Deed
Licencia CC
https://creativecommons.org/licenses/by/4.0/
Resumen
Aim: To evaluate postoperative complications and clinical evolution in patients undergoing colectomies and anastomosis with two preoperative strategies, mechanical bowel preparation alone (MBP) and mechanical bowel preparation with oral antibiotics (MBP+OA). Materials and Method: Retrospective study, with defined inclusion and exclusion criteria. Variables studied: preoperative demographic characteris-tics, surgical intervention, anastomotic location, anastomotic leakage (AL), surgical site infection (SSI), postoperative intestinal transit, Clostridium difficile (CD) infection and hospital stay. Statistical analysis, bivariate and multivariate models were performed. Results: 216 patients studied, 149 were MBP group and 67 MBP+OA group. The group MBP had higher rates of AL (7.38% vs. 0%, p = 0.011). For left-sided colectomies, AL rate in both groups had a higher difference in the middle rectum, with no cases in the MBP+OA group (0% vs. 50%, p = 0.019). For right colectomies, the AL rates were similar in both groups. SSI was higher in MBP group (4.7% vs. 0%, p = 0.037). The bowel transit recovery was faster for MBP+OA group, determining less hospital stay (3.98 days vs. 6.39 days, p = 0.001). The group MBP+OA had a higher rate of CD colitis, 4.48% (p = 0.008). Discussion and Conclusion: These results suggest that preoperative oral antibiotic with mechanical bowel preparation could help to prevent anastomotic leaks in left-sided colectomies, also avoid surgical site infection, favoring the recovery of postoperative bowel transit, reducing hospital stay. The association to CD should be examined in larger studies. © 2022, Sociedad de Cirujanos de Chile. All rights reserved.
Notas
Indexación: Scopus.
Palabras clave
Anastomotic leak, Bowel preparation, Colorectal surgery, Oral antibiotics
Citación
Revista de Cirugia, Volume 74, Issue 2, Pages 157 - 164, 2022
DOI
10.35687/s2452-454920220021331