6533b822fe1ef96bd127d771

RESEARCH PRODUCT

Association of mechanical bowel preparation with oral antibiotics and anastomotic leak following left sided colorectal resection: an international, multi-centre, prospective audit

The 2017 European Society Of Coloproctology (Escp) Collaborating Group Blanco-colino Kelly Singh Bhangu Pinkney Poskus El-hussuna Battersby N. J. Buchs N. C. Buskens Chaudri Frasson Gallo Minaya-bravo A. M. Morton Negoi Nepogodiev Pata Sánchez-guillén Zmora Perry Magill Altomare Bemelman Brown Denost Knowles Laurberg Lefevre J. H. Möeslein Pinkney Vaizey Bilali Bilali Salomon Cillo EstefaniaUriburu Patron Ruiz Farina Carballo Guckenheimer Proud Brouwer Bui Nguyen Smart Warwick Theodore J. E. Herbst Birsan Dauser Ghaffari Hartig Stift Argeny Unger Strouhal Heuberger Varabei Lahodzich Makhmudov Selniahina Feryn Leupe Maes ReynvoetLangenhove Van Nachtergaele Monami Francart Jehaes Markiewicz WeertsBelle Van Bomans Cavenaile Nijs Vertruyen Pletinckx Claeys Defoort MuysomsCleven Van Lange Vindevoghel Wolthuis Todorovic Dabic Kenjic Lovric Vidovic Delibegovic Mehmedovic Christiano Lombardi MarchioriR. J TerciotiR. J Dardanov Petkov Simonova Yonkov Zhivkov Maslyankov Pavlov Sokolov Todorov Stoyanov Batashki Iarumov Lozev Moshev Slavchev Atanasov Belev Krstev Penkov ŠAntak ĆOsić Previšić Vukušić Zukanović Zelić KršulVitlov Lekić Mendrila Orhalmi Dusek Maly Paral Sotona Skrovina Bencurik Machackova Kala Farkašová Grolich Procházka Hoch Kocian Martinek Antos Pruchova Ceccotti Madsbøll StraarupOvesen Uth Christensen Bondeven Edling ElfekiGameza AlexandrovichBach Michelsen Zheltiakova Krarup P. M. Krogh Rolff H. -C. Lykke Juvik A. F. Lóven H. H. K. Marckmann Osterkamp J. T. F. Madsen A. H. Worsøe Ugianskis Kjær M. D. Youn Cho Lee Khalid Kristensen M. H.El Sorogy Elgeidie ElhemalyEl Nakeeb Elrefai Shalaby Emile Omar Sakr Thabet Awny Metwally Refky Shams Zuhdy Lepistö Keränen Kivelä Lehtonen Siironen Rautio Ahonen-siirtola Klintrup Paarnio Takala Hyöty Haukijärvi Kotaluoto S. -M. Lehto Tomminen Huhtinen Carpelan Karvonen Rantala Varpe Cotte Francois Glehen Passot D'alessandro Chouillard Etienne J. C. 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Jotautas Mikalauskas Poskus Strupas Zakaria A. D. Lah N. N. Wong Zain W. Z. Zakaria MazlanAzman Mohd Z. A. Sagap Psaila Andrejevic Cini Ellul Pace Ahallat Hamid Hrora Majbar M. A. Raiss Westerduin Tanis Van Der Sluis P. C. Davids P. H. Pronk Schiphorst A. H. W. Smakman Zimmerman Koeter StijnsLoon Van Y. -T. VermaasDe Graaf DoorneboschHagen VanRuler Van Toorenvliet Nonner Van Den BergSteensel Van Vles Melenhorst Orsini Visschers Hoff Blom Marsman Mulder CenseDe Castro Demirkiran HunfeldGeloven VanDe Groof Hendriks LeeuwenburgOorschot Van Wit Rupert Veldman Keijzers KonstenBoer Den Corver Boerma E. G. Koolen MartensWijck Van Ignjatovic Breuer Gurpreet OreslandMoe Tetens NesbakkenBacke Flaaten Wik T. -A. Radiya Dehli Gjessing Norderval Woll Anwer Qureshi M. S. Qureshi A. U. Billah Jawad M. Y. 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Gómez Jareño Ríos Vercher García-gonzález J. -M. Cervera-aldama Ramos-prada Santamaría-olabarrieta Borda Enrriquez-navascués J. M. Saralegui Calero-lillo Aznar-puig López-lara M. A. Muñoz-collado Valverde-sintas Menendez Leon Truan Baldonedo Fernández-martínez Otero Solar-garcía Turrado-rodriguez De Lacy OliverFortuny Lacy A. M.Perez MartinPiñeiro Otero A. M. Paredes Fernandez Ladra M. J. Paulos Prieto Beltrán De Heredia J. P.Antona Blanco De Andrés AsenjoGarcía Ferreras Romero De Diego Cordoba Diaz De LaspraGallego EchazarretaGuedea Elia Escola MartinezRomaguera Primo Parreño Pastor RosellTrujillo LozoyaCompany AlósCarmona Ruiz M. D.Bueno SolanaRuiz SalvansGonçalves Alonso Jiménez-toscanoDamieta PascualRoman Pera Pellicer-franco E. M. Garcia-marin J. A. Mengual-ballester Soria-aledo Valero-navarro Vicente-ruiz Garcia-zamora Gonzalez-gil Montoya-tabares M. J. Paredes-quilesTrill Die Abadia Moreno Pina J. D.Rubio Ramos Escartin Blas J. L. Fernando FerrerEgea Garcia Pros Martinez Rius Socías SabiaValls CastellviSantin GonzalezGarcia MompartPons Viso Julià Codina-cazador Farrés Gómez Planellas Cuadrado Camps Rufas Escoll Fermiñán Muriel Sierra Alvarez-laso Lora Padin Garcia-septiem Bustamante Jimenez Jimenez-miramon Ramos J. L. Gallardo A. B. Benito Colao Galindo Garcia Forero-torresPoza AlonsoFernandez DieguezMartin GilsanzGarcia HernandezLópez Rojo J. A.López Gil J. M.Zunzárren GonzálezAlegre MartínezMatilla Zorrilla L. P. Navarro-sánchezSerrano Alcalá F. J. López-fernándezCabrera Montesdeoca Alvarez-gallego GuevaraMiguelañez Pascual Rubio-perezRuiz GomezMartín AlonsoFernández CagigasDiego Castillo Pando J. A. Maristany Muñoz-duyos Rada-palomino Vargas-pierolaRos PeñaBuleje Benavides J. A.Camarena Muñoz J. M.Baños Parra P. A.Faraco Ramirez Arenal J. J. Citores M. A. Marcos J. L. Sánchez TinocoFlórez García L. J.Pacheco Arias R. D.Ruiz MínguezCorral GutiérrezInfante RodríguezLópez Carrillo M. J.Prats Carrasco M. M.Laredo LageManzano MartínezGarcía Rodríguez Segura-sampedro J. J. Alonso-hernándezIsart FernandezCuesta GamundiSegui Ochogavia Ibañez Abrisqueta LujanPérez GómezValero CorralesSalazar MonjeCardenas SanchizHumanes Soler Jimenez-rodriguez R. M. De La PortillaPavon Diaz J. M.Cabrera Garcia A. M.Diaz Reyes M. L. Espin Marinello Martí Sanchez J. L. VallriberaMico Orts F. J.Navarro OrtinCliment PerezDiaz Serra Millan Caro Escuder Espina FeliuAira ClimentDiz EstévezAsencio Moreno M. T.Mato VarelaBouzán Vázquez Diez-alonso M. M. Villeta-plaza Guadalajara AlíasOlmo García Pastor ValverdeRomero Sanchez GardeaSantos Gil NimmersgernPaz Serrano Romero-simó Blasco-segura Caravaca-garcía Costa-navarro Zarco-pleguezuelos Flor-lorente García-granero García-granero Arencibia Alonso Febles Nogués E. M. Roque Segelman Nygren Nestler Abraham-nordling Egenvall Myrelid Jung Loftås Lydrup M. -L. Azahr Buchwald Mangell Syk Nikberg Carlander Chabok Smedh Tiselius Haapaniemi Benckert Adamina Freil-lanter Gingert Müller Schäfli Regusci Brenna Fasolini Misteli Kirchhoff Oertli Hahnloser Clerc Hübner Ris Chevallay Morel Schiltz Wang J. Y. Su W. -C. Huang C. -W. Ma C. -J. Tsai H. -L. Bugra Agalar Baloglu Basoglu Okkabaz Binboga Biricik Celik Yavuz Canda A. E. Agalar Fuzun Sokmen Terzi Isik Karip Bilgili A. C. Leventoğlu Aytac Küçükdiler Yıldız Yuksel Sinan Hancerliogullari Kaymak Kozak Ozer M. T. Sarici I. S. Akca Kalayci M. U. Kara Agcaoglu Balik Bayram ÖZbalcı G. S. ÖZkan B. B. Karabacak Sungurtekin Ozgen Demirbas ÖZtürk Isik Yilmazlar Colak Karagul Kinas Fearnhead Lord Stewart Zammit Arnold Broadhurst Moran Seretis Shabbir Jones Kynaston Vimalachandran Blower Mcfaul Mcwhirter Pilkington Wilson Chowdhary Stubbs Abdalkoddus Lai Thavanesan Yao Agarwal Dindyal Hill R. M. C. Reade Slesser Paterson Balfour Boland Geraghty O'kelly Patel Tezas Yahia Jadhav Marimuthu Narayanan Piramanayagam Bradley Buchanan Paul Singh Thomson Korsgen Bedford Lee Leong Mcarthur Malik Mohamed Cunha Pilavas Reddy Ahmed Ahmed Voll Velchuru Lal Mirshekar-syahkal Kassai Aleem Keogh-bootland Sarmah Keegan Kelkar Sen Oliveira-cunha Chaudhri Fares Thomas W. M. Aslam M. I. Boyle Hemingway Miller Norwood Gurjar Al-saeedi Anandan Sudlow Zampitis Malik Bogdan Smart Iqbal M. R. Bailey Lawes Omar Tamhane Evans Ather Lim Nageswaran Taylor Hunt Nicholls Shaikh Muscara O'brien Photi Stearns Meylemans Cunningham Hompes Tennakoon Kumarasinghe Rao Upanishad Khan Ahmad Shweejawee Stefan Smart Daniels Gregoir Longstaff Mcdermott Varcada Drami Gala Moggia Ratnatunga Harries Hayes Williams Raymond Bronder Davies Hawkin Ryska Ayral Beveridge Bhowmik Gill Simpson Schofield Mcardle Parmar Williamson Burton Courtney Grant Saracino Newton Epstein Branagan Bignell Symankewicz Zaman Mankotia Siddiqui Torrance Artioukh Eggleston Gokul Selwyn Warusavitarne Chandrasinghe Grainger Leo C. A. Harris Levy Skull Thaha Garg Patel Ramsanahie Mondragon-pritchardLeon Cuinas Shukla Brewer Fitzgerald Kho Torkington Tate Wheat Smolarek Platt Rossi Tham J. C. Knight Richardson Tzivanakis Gregori Ashraf M. A. Atif Santos Saffaf Canning Chandratreya Bowen Graham Hamad Kaubrys Chaudhry Z. U. Bhan Mukhtar Oshowo Wilson Gouvas Nicol Pandey Zilvetti Sharma Fatayer Mothe Rahman Curtis Allison Dalton Francis Ockrim Psaras Dudarovaska Marharint Mostovoy Voloshin Kolesnik Makhmudov Altinel Iqbal Cunningham Go Tan

subject

Laparoscopic surgeryMaleLeakmedicine.medical_specialtyCathartics/administration & dosagemedicine.drug_classmedicine.medical_treatmentAntibioticsanastomotic leakanastomotic leak; bowel preparation; colonic cancer; Colorectal surgery; laparoscopic surgery; Gastroenterology030230 surgeryAnastomosisPreoperative Care/methodsNO03 medical and health sciences0302 clinical medicineColorectal surgeryAnti-Bacterial Agents/administration & dosagePreoperative CareMedicineHumansrisk factorsProspective StudiesMulti centreProspective cohort studyColectomyAgedta3126Medical Auditbusiness.industryCatharticsdigestive oral and skin physiologyGastroenterologycolonic cancerMiddle Agedlaparoscopic surgeryColorectal surgerydigestive system diseasesSurgeryAnti-Bacterial Agents030220 oncology & carcinogenesisBowel preparationbowel preparationDrug Therapy CombinationFemaleColectomy/adverse effectsbusinessAnastomotic Leak/etiology

description

INTRODUCTION: The optimal bowel preparation strategy to minimise the risk of anastomotic leak is yet to be determined. This study aimed to determine whether oral antibiotics combined with mechanical bowel preparation (MBP+Abx) was associated with a reduced risk of anastomotic leak when compared to mechanical bowel preparation alone (MBP) or no bowel preparation (NBP).METHODS: A pre-planned analysis of the European Society of Coloproctology (ESCP) 2017 Left Sided Colorectal Resection audit was performed. Patients undergoing elective left sided colonic or rectal resection with primary anastomosis between 1 January 2017 and 15 March 2017 by any operative approach were included. The primary outcome measure was anastomotic leak.RESULTS: Of 3676 patients across 343 centres in 47 countries, 618 (16.8%) received MBP+ABx, 1945 MBP (52.9%) and 1099 patients NBP (29.9%). Patients undergoing MBP+ABx had the lowest overall rate of anastomotic leak (6.1%, 9.2%, 8.7% respectively) in unadjusted analysis. After case-mix adjustment using a mixed-effects multivariable regression model, MBP+Abx was associated with a lower risk of anastomotic leak (OR 0.52, 0.30-0.92, P = 0.02) but MBP was not (OR 0.92, 0.63-1.36, P = 0.69) compared to NBP.CONCLUSION: This non-randomised study adds 'real-world', contemporaneous, and prospective evidence of the beneficial effects of combined mechanical bowel preparation and oral antibiotics in the prevention of anastomotic leak following left sided colorectal resection across diverse settings. We have also demonstrated limited uptake of this strategy in current international colorectal practice.

yearjournalcountryeditionlanguage
2018-09-01
10.1111/codi.14362http://hdl.handle.net/11383/2076979