Mechanical bowel preparation combined with oral antibiotics in colorectal cancer surgery: a nationwide population-based study

Background The guidelines for reducing surgical site infection in colorectal surgery recommend mechanical bowel preparation with oral antibiotics; however, this recommendation remains controversial. This study aimed to reveal the effect of oral antibiotics combined with mechanical bowel preparation...

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Veröffentlicht in:International journal of colorectal disease 2021-09, Vol.36 (9), p.1929-1935
Hauptverfasser: Lee, Jun Ho, Ahn, Byung Kyu, Ryu, Jiin, Lee, Kang Hong
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container_end_page 1935
container_issue 9
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container_title International journal of colorectal disease
container_volume 36
creator Lee, Jun Ho
Ahn, Byung Kyu
Ryu, Jiin
Lee, Kang Hong
description Background The guidelines for reducing surgical site infection in colorectal surgery recommend mechanical bowel preparation with oral antibiotics; however, this recommendation remains controversial. This study aimed to reveal the effect of oral antibiotics combined with mechanical bowel preparation in colorectal surgery. Methods This study was a nationwide population-based retrospective study. Data between January 1, 2016, and December 31, 2018, from the Korean National Health Insurance Service database were analyzed. Patients who underwent elective colorectal cancer surgery were included. Results A total of 20,740 patients were finally included, comprising 14,554 (70.2%) who underwent mechanical bowel preparation alone and 6186 (29.8%) who underwent mechanical bowel preparation with oral antibiotics. The mechanical bowel preparation alone group was older than the mechanical bowel preparation with oral antibiotics group (65.7 ± 11.9 vs. 64.7 ± 11.8 years, p  
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This study aimed to reveal the effect of oral antibiotics combined with mechanical bowel preparation in colorectal surgery. Methods This study was a nationwide population-based retrospective study. Data between January 1, 2016, and December 31, 2018, from the Korean National Health Insurance Service database were analyzed. Patients who underwent elective colorectal cancer surgery were included. Results A total of 20,740 patients were finally included, comprising 14,554 (70.2%) who underwent mechanical bowel preparation alone and 6186 (29.8%) who underwent mechanical bowel preparation with oral antibiotics. The mechanical bowel preparation alone group was older than the mechanical bowel preparation with oral antibiotics group (65.7 ± 11.9 vs. 64.7 ± 11.8 years, p  &lt; 0.001). Rectal cancer patients and patients who underwent open surgery were more likely to receive mechanical bowel preparation with oral antibiotics. Patients who underwent mechanical bowel preparation with oral antibiotics demonstrated lower surgical-site infection rate (2.9% vs. 9.4%, p  &lt; 0.001), shorter hospital stay (11.7 ± 5.5 vs. 13.5 ± 7.3 days, p  &lt; 0.001), and lower medical cost (US$7414 ± 2762 vs. US$7791 ± 3235, p  &lt; 0.001) than those who underwent mechanical bowel preparation alone. The 30-day readmission rates and mortality were not significantly different. Conclusions The use of mechanical bowel preparation with oral antibiotics reduces surgical site infection, hospital stay, and medical cost in colorectal cancer surgery.</description><identifier>ISSN: 0179-1958</identifier><identifier>EISSN: 1432-1262</identifier><identifier>DOI: 10.1007/s00384-021-03967-x</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Analysis ; Antibiotics ; Cancer ; Cancer surgery ; Colorectal cancer ; Colorectal carcinoma ; Colorectal surgery ; Gastroenterology ; Hepatology ; Infection ; Infection control ; Internal Medicine ; Intestine ; Medical care, Cost of ; Medicine ; Medicine &amp; Public Health ; Metronidazole ; National health insurance ; Oncology, Experimental ; Original Article ; Patients ; Population studies ; Population-based studies ; Proctology ; Rifaximin ; Surgery ; Surgical site infections</subject><ispartof>International journal of colorectal disease, 2021-09, Vol.36 (9), p.1929-1935</ispartof><rights>The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2021</rights><rights>COPYRIGHT 2021 Springer</rights><rights>The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2021.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c419t-8db26e2398430aeb3935f1021e21ee869fc77354d4eacd2e0f772ff6e38b3aa23</citedby><cites>FETCH-LOGICAL-c419t-8db26e2398430aeb3935f1021e21ee869fc77354d4eacd2e0f772ff6e38b3aa23</cites><orcidid>0000-0003-3857-9137</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00384-021-03967-x$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00384-021-03967-x$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids></links><search><creatorcontrib>Lee, Jun Ho</creatorcontrib><creatorcontrib>Ahn, Byung Kyu</creatorcontrib><creatorcontrib>Ryu, Jiin</creatorcontrib><creatorcontrib>Lee, Kang Hong</creatorcontrib><title>Mechanical bowel preparation combined with oral antibiotics in colorectal cancer surgery: a nationwide population-based study</title><title>International journal of colorectal disease</title><addtitle>Int J Colorectal Dis</addtitle><description>Background The guidelines for reducing surgical site infection in colorectal surgery recommend mechanical bowel preparation with oral antibiotics; however, this recommendation remains controversial. This study aimed to reveal the effect of oral antibiotics combined with mechanical bowel preparation in colorectal surgery. Methods This study was a nationwide population-based retrospective study. Data between January 1, 2016, and December 31, 2018, from the Korean National Health Insurance Service database were analyzed. Patients who underwent elective colorectal cancer surgery were included. Results A total of 20,740 patients were finally included, comprising 14,554 (70.2%) who underwent mechanical bowel preparation alone and 6186 (29.8%) who underwent mechanical bowel preparation with oral antibiotics. The mechanical bowel preparation alone group was older than the mechanical bowel preparation with oral antibiotics group (65.7 ± 11.9 vs. 64.7 ± 11.8 years, p  &lt; 0.001). Rectal cancer patients and patients who underwent open surgery were more likely to receive mechanical bowel preparation with oral antibiotics. Patients who underwent mechanical bowel preparation with oral antibiotics demonstrated lower surgical-site infection rate (2.9% vs. 9.4%, p  &lt; 0.001), shorter hospital stay (11.7 ± 5.5 vs. 13.5 ± 7.3 days, p  &lt; 0.001), and lower medical cost (US$7414 ± 2762 vs. US$7791 ± 3235, p  &lt; 0.001) than those who underwent mechanical bowel preparation alone. The 30-day readmission rates and mortality were not significantly different. Conclusions The use of mechanical bowel preparation with oral antibiotics reduces surgical site infection, hospital stay, and medical cost in colorectal cancer surgery.</description><subject>Analysis</subject><subject>Antibiotics</subject><subject>Cancer</subject><subject>Cancer surgery</subject><subject>Colorectal cancer</subject><subject>Colorectal carcinoma</subject><subject>Colorectal surgery</subject><subject>Gastroenterology</subject><subject>Hepatology</subject><subject>Infection</subject><subject>Infection control</subject><subject>Internal Medicine</subject><subject>Intestine</subject><subject>Medical care, Cost of</subject><subject>Medicine</subject><subject>Medicine &amp; Public Health</subject><subject>Metronidazole</subject><subject>National health insurance</subject><subject>Oncology, Experimental</subject><subject>Original Article</subject><subject>Patients</subject><subject>Population studies</subject><subject>Population-based studies</subject><subject>Proctology</subject><subject>Rifaximin</subject><subject>Surgery</subject><subject>Surgical site infections</subject><issn>0179-1958</issn><issn>1432-1262</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><recordid>eNp9kU9rFTEUxYMo-Kx-AVcBN25S82-SGXelWC1U3Og6ZDI3bcq8ZEwyvL5Fv7t57wlFEUkg3OR3DvfmIPSW0XNGqf5QKBW9JJQzQsWgNHl4hjZMCk4YV_w52lCmB8KGrn-JXpVyT1uttNygx6_g7mwMzs54TDuY8ZJhsdnWkCJ2aTuGCBPehXqHU26QjTWMIdXgCg4HYk4ZXG0vzkYHGZc130Lef8QWx6PLLkyAl7Ss87Ekoy3NsdR12r9GL7ydC7z5fZ6hH1efvl9-ITffPl9fXtwQJ9lQST-NXAEXQy8FtTCKQXSetWGhbejV4J3WopOTBOsmDtRrzb1XIPpRWMvFGXp_8l1y-rlCqWYbioN5thHSWgzvhFZSc9k19N1f6H1ac2zdNaobGOdCqSfq1s5gQvSpZusOpuZCMyl7TQVt1Pk_qLYm2AaXIvjQ7v8Q8JPA5VRKBm-WHLY27w2j5hC0OQVt2uzmGLR5aCJxEpUGx_b3Tx3_R_ULkXKssw</recordid><startdate>20210901</startdate><enddate>20210901</enddate><creator>Lee, Jun Ho</creator><creator>Ahn, Byung Kyu</creator><creator>Ryu, Jiin</creator><creator>Lee, Kang Hong</creator><general>Springer Berlin Heidelberg</general><general>Springer</general><general>Springer Nature B.V</general><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>H94</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-3857-9137</orcidid></search><sort><creationdate>20210901</creationdate><title>Mechanical bowel preparation combined with oral antibiotics in colorectal cancer surgery: a nationwide population-based study</title><author>Lee, Jun Ho ; Ahn, Byung Kyu ; Ryu, Jiin ; Lee, Kang Hong</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c419t-8db26e2398430aeb3935f1021e21ee869fc77354d4eacd2e0f772ff6e38b3aa23</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Analysis</topic><topic>Antibiotics</topic><topic>Cancer</topic><topic>Cancer surgery</topic><topic>Colorectal cancer</topic><topic>Colorectal carcinoma</topic><topic>Colorectal surgery</topic><topic>Gastroenterology</topic><topic>Hepatology</topic><topic>Infection</topic><topic>Infection control</topic><topic>Internal Medicine</topic><topic>Intestine</topic><topic>Medical care, Cost of</topic><topic>Medicine</topic><topic>Medicine &amp; Public Health</topic><topic>Metronidazole</topic><topic>National health insurance</topic><topic>Oncology, Experimental</topic><topic>Original Article</topic><topic>Patients</topic><topic>Population studies</topic><topic>Population-based studies</topic><topic>Proctology</topic><topic>Rifaximin</topic><topic>Surgery</topic><topic>Surgical site infections</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lee, Jun Ho</creatorcontrib><creatorcontrib>Ahn, Byung Kyu</creatorcontrib><creatorcontrib>Ryu, Jiin</creatorcontrib><creatorcontrib>Lee, Kang Hong</creatorcontrib><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health &amp; Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>International journal of colorectal disease</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lee, Jun Ho</au><au>Ahn, Byung Kyu</au><au>Ryu, Jiin</au><au>Lee, Kang Hong</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Mechanical bowel preparation combined with oral antibiotics in colorectal cancer surgery: a nationwide population-based study</atitle><jtitle>International journal of colorectal disease</jtitle><stitle>Int J Colorectal Dis</stitle><date>2021-09-01</date><risdate>2021</risdate><volume>36</volume><issue>9</issue><spage>1929</spage><epage>1935</epage><pages>1929-1935</pages><issn>0179-1958</issn><eissn>1432-1262</eissn><abstract>Background The guidelines for reducing surgical site infection in colorectal surgery recommend mechanical bowel preparation with oral antibiotics; however, this recommendation remains controversial. This study aimed to reveal the effect of oral antibiotics combined with mechanical bowel preparation in colorectal surgery. Methods This study was a nationwide population-based retrospective study. Data between January 1, 2016, and December 31, 2018, from the Korean National Health Insurance Service database were analyzed. Patients who underwent elective colorectal cancer surgery were included. Results A total of 20,740 patients were finally included, comprising 14,554 (70.2%) who underwent mechanical bowel preparation alone and 6186 (29.8%) who underwent mechanical bowel preparation with oral antibiotics. The mechanical bowel preparation alone group was older than the mechanical bowel preparation with oral antibiotics group (65.7 ± 11.9 vs. 64.7 ± 11.8 years, p  &lt; 0.001). Rectal cancer patients and patients who underwent open surgery were more likely to receive mechanical bowel preparation with oral antibiotics. Patients who underwent mechanical bowel preparation with oral antibiotics demonstrated lower surgical-site infection rate (2.9% vs. 9.4%, p  &lt; 0.001), shorter hospital stay (11.7 ± 5.5 vs. 13.5 ± 7.3 days, p  &lt; 0.001), and lower medical cost (US$7414 ± 2762 vs. US$7791 ± 3235, p  &lt; 0.001) than those who underwent mechanical bowel preparation alone. The 30-day readmission rates and mortality were not significantly different. Conclusions The use of mechanical bowel preparation with oral antibiotics reduces surgical site infection, hospital stay, and medical cost in colorectal cancer surgery.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><doi>10.1007/s00384-021-03967-x</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0003-3857-9137</orcidid></addata></record>
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subjects Analysis
Antibiotics
Cancer
Cancer surgery
Colorectal cancer
Colorectal carcinoma
Colorectal surgery
Gastroenterology
Hepatology
Infection
Infection control
Internal Medicine
Intestine
Medical care, Cost of
Medicine
Medicine & Public Health
Metronidazole
National health insurance
Oncology, Experimental
Original Article
Patients
Population studies
Population-based studies
Proctology
Rifaximin
Surgery
Surgical site infections
title Mechanical bowel preparation combined with oral antibiotics in colorectal cancer surgery: a nationwide population-based study
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