期刊
LANGENBECKS ARCHIVES OF SURGERY
卷 401, 期 5, 页码 573-580出版社
SPRINGER
DOI: 10.1007/s00423-016-1461-9
关键词
Colorectal resection; Mechanical bowel preparation; Antibiotics; Surgical site infection; Anastomotic leak; Postoperative outcomes; Quality
类别
Back in the 1970s, the administration of oral antibiotics combined with mechanical bowel preparation prior to colorectal surgery was considered standard procedure and adopted widely. Subsequent evidence suggested that bowel cleansing was unnecessary, even harmful, and hence was abandoned. Most recent evidence, however, suggests that full preparation significantly improves a spectrum of colectomy-specific postoperative outcomes. The purpose of this review was to describe existing literature regarding the optimal bowel preparation regimen prior to elective colorectal resection. In addition, we evaluate the available evidence on each component-oral antibiotics, mechanical bowel preparation and intravenous antibiotics, with regard to short-term postoperative outcomes. Current best evidence suggests that colorectal resection should be preceded by a combination of oral antibiotics, mechanical bowel preparation and intravenous antibiotics at induction. Further randomized controlled trials are required due to a paucity of level 1 evidence.
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