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International Journal of Colorectal Disease

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01-01-2018 | Original Article

Local antibiotic decontamination to prevent anastomotic leakage short-term outcome in rectal cancer surgery

Authors: Ulrich Wirth, Susanne Rogers, Kristina Haubensak, Stefan Schopf, Thomas von Ahnen, Hans Martin Schardey

Published in: International Journal of Colorectal Disease | Issue 1/2018

Abstract

Purpose

Anastomotic leakage still presents an issue in rectal cancer surgery with rates of about 11%. As bacteria play a critical role, there is the concept of perioperative local decontamination to prevent anastomotic leakage.

Methods

To ascertain the effectiveness of this treatment, we performed a retrospective analysis on 206 rectal resections with primary anastomosis and routine use of a selective decontamination of the digestive tract (SDD) regimen for local decontamination. SDD medication was administered every 8 h from the day before surgery to the seventh postoperative day. All patients were treated according to the fast-track protocol without mechanical bowel preparation; instead, a laxative was used.

Results

Overall morbidity was 30%, overall mortality 0.5%. In our data, overall rate of anastomotic leakage (AL) was 5.8%, with 3.9% in anterior rectal resection and 6.5% in low anterior rectal resection group. In 75% of cases, anastomotic leakage was grade “C” and needed re-laparotomy. Surgical site infection rate was 19.9%. No serious adverse events were related to decontamination.

Conclusion

Local antibiotic decontamination appears to be safe and effective to decrease the rate of anastomotic leakage in rectal cancer surgery. Further focus should be on perioperative management including bowel preparation and choice of antimicrobial agents for local decontamination.

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Title: Local antibiotic decontamination to prevent anastomotic leakage short-term outcome in rectal cancer surgery
Authors: Ulrich Wirth
Susanne Rogers
Kristina Haubensak
Stefan Schopf
Thomas von Ahnen
Hans Martin Schardey
Publication date: 01-01-2018
Publisher: Springer Berlin Heidelberg
Published in: International Journal of Colorectal Disease / Issue 1/2018
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI: https://doi.org/10.1007/s00384-017-2933-2

At a glance: The STEP trials

Springer Medicine

Local antibiotic decontamination to prevent anastomotic leakage short-term outcome in rectal cancer surgery

Abstract

Purpose

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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