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Published in: World Journal of Surgical Oncology 1/2018

Open Access 01-12-2018 | Research

Current practice patterns of preoperative bowel preparation in colorectal surgery: a nation-wide survey by the Chinese Society of Colorectal Cancer

Authors: Zheng Liu, Ming Yang, Zhi-xun Zhao, Xu Guan, Zheng Jiang, Hai-peng Chen, Song Wang, Ji-chuan Quan, Run-kun Yang, Xi-shan Wang

Published in: World Journal of Surgical Oncology | Issue 1/2018

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Abstract

Background

The optimal preoperative bowel preparation for colorectal surgery remains controversial. However, recent studies have established that bowel preparation varies significantly among countries and even surgeons at the same institution. This survey aimed to obtain information on the current practice patterns of bowel preparation for colorectal surgery in China.

Methods

A paper-based survey was circulated to the members of the Chinese Society of Colorectal Cancer (CSCC). The survey responses were collected and analyzed. Statistical analysis was performed for all the categorical variables according to the responses to individual questions.

Results

Three hundred forty-one members completed the questionnaire. Regarding surgical practice, 203 (59.5%) performed > 50% of the colorectal operations laparoscopically or robotically; the use of mechanical bowel preparation (MBP) alone was significantly higher (63.5 vs 31.9%; P < 0.001). The respondents who performed > 200 colonic or rectal resections provided significantly more MBP alone (79.6 vs 39.1%, P < 0.001; 76.6 vs 43.2%, P < 0.001; respectively). Among hospitals with fewer than 500 beds, 52.4% of the respondents used MBP + oral antibiotics preparation (OAP) + enema, a significantly higher percentage than the respondents of hospitals with more than 500 beds (P < 0.001). Nearly 40% of the respondents prescribed OAP in regimens; meanwhile, 74.8% prescribed preoperative intravenous antibiotics.

Conclusions

The study demonstrates considerable variation among members from the CSCC. These findings should be considered when developing multicenter trials and to provide more definitive answers.
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Literature
1.
go back to reference Slim K, Kartheuser A. Mechanical bowel preparation before colorectal surgery in enhanced recovery programs: discrepancy between the American and European guidelines. Dis Colon Rectum. 2018;61:e13–4.CrossRefPubMed Slim K, Kartheuser A. Mechanical bowel preparation before colorectal surgery in enhanced recovery programs: discrepancy between the American and European guidelines. Dis Colon Rectum. 2018;61:e13–4.CrossRefPubMed
2.
go back to reference Parthasarathy M, Greensmith M, Bowers D, Groot-Wassink T. Risk factors for anastomotic leakage after colorectal resection: a retrospective analysis of 17 518 patients. Color Dis. 2017;19:288–98.CrossRef Parthasarathy M, Greensmith M, Bowers D, Groot-Wassink T. Risk factors for anastomotic leakage after colorectal resection: a retrospective analysis of 17 518 patients. Color Dis. 2017;19:288–98.CrossRef
3.
go back to reference Midura EF, Jung AD, Hanseman DJ, Dhar V, Shah SA, Rafferty JF, Davis BR, Paquette IM. Combination oral and mechanical bowel preparations decreases complications in both right and left colectomy. Surgery. 2018;163:528–34.CrossRefPubMed Midura EF, Jung AD, Hanseman DJ, Dhar V, Shah SA, Rafferty JF, Davis BR, Paquette IM. Combination oral and mechanical bowel preparations decreases complications in both right and left colectomy. Surgery. 2018;163:528–34.CrossRefPubMed
4.
go back to reference Mik M, Berut M, Trzcinski R, Dziki L, Buczynski J, Dziki A. Preoperative oral antibiotics reduce infections after colorectal cancer surgery. Langenbeck’s Arch Surg. 2016;401:1153–62.CrossRef Mik M, Berut M, Trzcinski R, Dziki L, Buczynski J, Dziki A. Preoperative oral antibiotics reduce infections after colorectal cancer surgery. Langenbeck’s Arch Surg. 2016;401:1153–62.CrossRef
5.
go back to reference Anjum N, Ren J, Wang G, Li G, Wu X, Dong H, Wu Q, Li J. A randomized control trial of preoperative oral antibiotics as adjunct therapy to systemic antibiotics for preventing surgical site infection in clean contaminated, contaminated, and dirty type of colorectal surgeries. Dis Colon Rectum. 2017;60:1291–8.CrossRefPubMed Anjum N, Ren J, Wang G, Li G, Wu X, Dong H, Wu Q, Li J. A randomized control trial of preoperative oral antibiotics as adjunct therapy to systemic antibiotics for preventing surgical site infection in clean contaminated, contaminated, and dirty type of colorectal surgeries. Dis Colon Rectum. 2017;60:1291–8.CrossRefPubMed
6.
go back to reference Vo E, Massarweh NN, Chai CY, Tran Cao HS, Zamani N, Abraham S, Adigun K, Awad SS. Association of the addition of oral antibiotics to mechanical bowel preparation for left colon and rectal cancer resections with reduction of surgical site infections. JAMA Surg. 2018;153:114–21.CrossRefPubMed Vo E, Massarweh NN, Chai CY, Tran Cao HS, Zamani N, Abraham S, Adigun K, Awad SS. Association of the addition of oral antibiotics to mechanical bowel preparation for left colon and rectal cancer resections with reduction of surgical site infections. JAMA Surg. 2018;153:114–21.CrossRefPubMed
7.
go back to reference Ohman KA, Wan L, Guthrie T, Johnston B, Leinicke JA, Glasgow SC, Hunt SR, Mutch MG, Wise PE, Silviera ML. Combination of oral antibiotics and mechanical bowel preparation reduces surgical site infection in colorectal surgery. J Am Coll Surg. 2017;225:465–71.CrossRefPubMed Ohman KA, Wan L, Guthrie T, Johnston B, Leinicke JA, Glasgow SC, Hunt SR, Mutch MG, Wise PE, Silviera ML. Combination of oral antibiotics and mechanical bowel preparation reduces surgical site infection in colorectal surgery. J Am Coll Surg. 2017;225:465–71.CrossRefPubMed
8.
go back to reference Garfinkle R, Abou-Khalil J, Morin N, Ghitulescu G, Vasilevsky CA, Gordon P, Demian M, Boutros M. Is there a role for oral antibiotic preparation alone before colorectal surgery? ACS-NSQIP analysis by coarsened exact matching. Dis Colon Rectum. 2017;60:729–37.CrossRefPubMed Garfinkle R, Abou-Khalil J, Morin N, Ghitulescu G, Vasilevsky CA, Gordon P, Demian M, Boutros M. Is there a role for oral antibiotic preparation alone before colorectal surgery? ACS-NSQIP analysis by coarsened exact matching. Dis Colon Rectum. 2017;60:729–37.CrossRefPubMed
10.
go back to reference Nichols RL, Smith JW, Garcia RY, Waterman RS, Holmes JW. Current practices of preoperative bowel preparation among North American colorectal surgeons. Clin Infect Dis. 1997;24:609–19.CrossRefPubMed Nichols RL, Smith JW, Garcia RY, Waterman RS, Holmes JW. Current practices of preoperative bowel preparation among North American colorectal surgeons. Clin Infect Dis. 1997;24:609–19.CrossRefPubMed
11.
go back to reference Cannon JA, Altom LK, Deierhoi RJ, Morris M, Richman JS, Vick CC, Itani KM, Hawn MT. Preoperative oral antibiotics reduce surgical site infection following elective colorectal resections. Dis Colon Rectum. 2012;55:1160–6.CrossRefPubMed Cannon JA, Altom LK, Deierhoi RJ, Morris M, Richman JS, Vick CC, Itani KM, Hawn MT. Preoperative oral antibiotics reduce surgical site infection following elective colorectal resections. Dis Colon Rectum. 2012;55:1160–6.CrossRefPubMed
12.
go back to reference Scarborough JE, Mantyh CR, Sun Z, Migaly J. Combined mechanical and oral antibiotic bowel preparation reduces incisional surgical site infection and anastomotic leak rates after elective colorectal resection: an analysis of Colectomy-Targeted ACS NSQIP. Ann Surg. 2015;262:331–7.CrossRefPubMed Scarborough JE, Mantyh CR, Sun Z, Migaly J. Combined mechanical and oral antibiotic bowel preparation reduces incisional surgical site infection and anastomotic leak rates after elective colorectal resection: an analysis of Colectomy-Targeted ACS NSQIP. Ann Surg. 2015;262:331–7.CrossRefPubMed
13.
go back to reference Contant CM, Hop WC, van't Sant HP, Oostvogel HJ, Smeets HJ, Stassen LP, Neijenhuis PA, Idenburg FJ, Dijkhuis CM, Heres P, van Tets WF, Gerritsen JJ, Weidema WF. Mechanical bowel preparation for elective colorectal surgery: a multicentre randomised trial. Lancet. 2007;370:2112–7.CrossRefPubMed Contant CM, Hop WC, van't Sant HP, Oostvogel HJ, Smeets HJ, Stassen LP, Neijenhuis PA, Idenburg FJ, Dijkhuis CM, Heres P, van Tets WF, Gerritsen JJ, Weidema WF. Mechanical bowel preparation for elective colorectal surgery: a multicentre randomised trial. Lancet. 2007;370:2112–7.CrossRefPubMed
14.
15.
go back to reference Bucher P, Gervaz P, Soravia C, Mermillod B, Erne M, Morel P. Randomized clinical trial of mechanical bowel preparation versus no preparation before elective left-sided colorectal surgery. Br J Surg. 2005;92:409–14.CrossRefPubMed Bucher P, Gervaz P, Soravia C, Mermillod B, Erne M, Morel P. Randomized clinical trial of mechanical bowel preparation versus no preparation before elective left-sided colorectal surgery. Br J Surg. 2005;92:409–14.CrossRefPubMed
16.
go back to reference Jung B, Påhlman L, Nyström PO, Nilsson E; Mechanical Bowel Preparation Study Group. Multicentre randomized clinical trial of mechanical bowel preparation in elective colonic resection. Br J Surg 2007;94:689–695. Jung B, Påhlman L, Nyström PO, Nilsson E; Mechanical Bowel Preparation Study Group. Multicentre randomized clinical trial of mechanical bowel preparation in elective colonic resection. Br J Surg 2007;94:689–695.
17.
go back to reference Zmora O, Wexner SD, Hajjar L, Park T, Efron JE, Nogueras JJ, Weiss EG. Trends in preparation for colorectal surgery: survey of the members of the American Society of Colon and Rectal Surgeons. Am Surg. 2003;69:150–4.PubMed Zmora O, Wexner SD, Hajjar L, Park T, Efron JE, Nogueras JJ, Weiss EG. Trends in preparation for colorectal surgery: survey of the members of the American Society of Colon and Rectal Surgeons. Am Surg. 2003;69:150–4.PubMed
18.
go back to reference Solla JA, Rothenberger DA. Preoperative bowel preparation. A survey of colon and rectal surgeons. Dis Colon Rectum. 1990;33:154–9.CrossRefPubMed Solla JA, Rothenberger DA. Preoperative bowel preparation. A survey of colon and rectal surgeons. Dis Colon Rectum. 1990;33:154–9.CrossRefPubMed
19.
go back to reference Watanabe M, Murakami M, Aoki T, Takahashi K, Yasuno M, Masaki T, Itabashi M, Yoshimatsu K, Saida Y, Funahashi K, Kan H, Ota M. The current perioperative care in elective colorectal surgery in Japan: a questionnaire survey of members of the Tokyo Colon Seminar Committee. Nihon Daicho Komonbyo Gakkai Zasshi. 2015;68:391–402.CrossRef Watanabe M, Murakami M, Aoki T, Takahashi K, Yasuno M, Masaki T, Itabashi M, Yoshimatsu K, Saida Y, Funahashi K, Kan H, Ota M. The current perioperative care in elective colorectal surgery in Japan: a questionnaire survey of members of the Tokyo Colon Seminar Committee. Nihon Daicho Komonbyo Gakkai Zasshi. 2015;68:391–402.CrossRef
20.
go back to reference Slim K, Martin G. Mechanical bowel preparation before colorectal surgery. Where do we stand? J Visc Surg. 2016;153(2):85–7.CrossRefPubMed Slim K, Martin G. Mechanical bowel preparation before colorectal surgery. Where do we stand? J Visc Surg. 2016;153(2):85–7.CrossRefPubMed
21.
go back to reference Carmichael JC, Keller DS, Baldini G, Bordeianou L, Weiss E, Lee L, Boutros M, McClane J, Feldman LS, Steele SR. Clinical practice guidelines for enhanced recovery after colon and rectal surgery from the American Society of Colon and Rectal Surgeons and Society of American Gastrointestinal and Endoscopic Surgeons. Dis Colon Rectum. 2017;60:761–84.CrossRefPubMed Carmichael JC, Keller DS, Baldini G, Bordeianou L, Weiss E, Lee L, Boutros M, McClane J, Feldman LS, Steele SR. Clinical practice guidelines for enhanced recovery after colon and rectal surgery from the American Society of Colon and Rectal Surgeons and Society of American Gastrointestinal and Endoscopic Surgeons. Dis Colon Rectum. 2017;60:761–84.CrossRefPubMed
22.
go back to reference Devane LA, Proud D, O'Connell PR, Panis Y. A European survey of bowel preparation in colorectal surgery. Color Dis. 2017;19:O402–6.CrossRef Devane LA, Proud D, O'Connell PR, Panis Y. A European survey of bowel preparation in colorectal surgery. Color Dis. 2017;19:O402–6.CrossRef
23.
go back to reference Drummond RJ, McKenna RM, Wright DM. Current practice in bowel preparation for colorectal surgery: a survey of the members of the Association of Coloproctology of GB & Ireland. Color Dis. 2011;13:708–10.CrossRef Drummond RJ, McKenna RM, Wright DM. Current practice in bowel preparation for colorectal surgery: a survey of the members of the Association of Coloproctology of GB & Ireland. Color Dis. 2011;13:708–10.CrossRef
24.
go back to reference Chan MY, Foo CC, Poon JT, Law WL. Laparoscopic colorectal resections with and without routine mechanical bowel preparation: A comparative study. Ann Med Surg (Lond). 2016;9:72–6. Chan MY, Foo CC, Poon JT, Law WL. Laparoscopic colorectal resections with and without routine mechanical bowel preparation: A comparative study. Ann Med Surg (Lond). 2016;9:72–6.
25.
go back to reference Koller SE, Bauer KW, Egleston BL, Smith R, Philp MM, Ross HM, Esnaola NF. Comparative effectiveness and risks of bowel preparation before elective colorectal surgery. Ann Surg. 2018;267:734–42.CrossRefPubMed Koller SE, Bauer KW, Egleston BL, Smith R, Philp MM, Ross HM, Esnaola NF. Comparative effectiveness and risks of bowel preparation before elective colorectal surgery. Ann Surg. 2018;267:734–42.CrossRefPubMed
26.
go back to reference Niv G, Grinberg T, Dickman R, Wasserberg N, Niv Y. Perforation and mortality after cleansing enema for acute constipation are not rare but are preventable. Int J Gen Med. 2013;6:323–8. Niv G, Grinberg T, Dickman R, Wasserberg N, Niv Y. Perforation and mortality after cleansing enema for acute constipation are not rare but are preventable. Int J Gen Med. 2013;6:323–8.
Metadata
Title
Current practice patterns of preoperative bowel preparation in colorectal surgery: a nation-wide survey by the Chinese Society of Colorectal Cancer
Authors
Zheng Liu
Ming Yang
Zhi-xun Zhao
Xu Guan
Zheng Jiang
Hai-peng Chen
Song Wang
Ji-chuan Quan
Run-kun Yang
Xi-shan Wang
Publication date
01-12-2018
Publisher
BioMed Central
Published in
World Journal of Surgical Oncology / Issue 1/2018
Electronic ISSN: 1477-7819
DOI
https://doi.org/10.1186/s12957-018-1440-4

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