Perioperative Selective Decontamination of the Digestive Tract (SDD) in Elective Colorectal Surgery

被引:22
|
作者
Roos, Daphne [1 ]
Dijksman, Lea M. [2 ]
Sondermeijer, Brigitte M. [1 ]
Oudemans-van Straaten, Heleen M. [3 ]
de Wit, Laurens T. [1 ]
Gerhards, Michael F. [1 ]
机构
[1] Onze Lieve Vrouw Hosp, Dept Surg, NL-1091 AC Amsterdam, Netherlands
[2] Onze Lieve Vrouw Hosp, Teaching Hosp, NL-1091 AC Amsterdam, Netherlands
[3] Onze Lieve Vrouw Hosp, Intens Care Unit, NL-1091 AC Amsterdam, Netherlands
关键词
Selective decontamination; Colorectal surgery; Postoperative complications; Infections; Anastomotic leakage; RISK-FACTORS; ANTIMICROBIAL PROPHYLAXIS; ANASTOMOTIC LEAKAGE; CONTROLLED-TRIALS; INFECTION; PREVENTION; MORTALITY; CANCER; COLON; COLONIZATION;
D O I
10.1007/s11605-009-0970-z
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Background Selective decontamination of the digestive tract (SDD) decreases morbidity and mortality in critically ill patients and morbidity in patients undergoing esophageal resection. This study analyzes the effect of perioperative SDD in patients undergoing elective colorectal Surgery on postoperative infections and anastomotic leakage. Methods This is a retrospective analysis of prospectively collected data in a 3-year cohort of 162 patients undergoing elective resection of colon and or rectum. Of these patients, 76 (47%) received SDD (polymyxine B sulfate, tobramycin, and amphotericin) perioperatively. The control group consisted of 86 patients who were not treated with SDD. Postoperative complications, hospital stay, and mortality were analyzed. Results In the SDD group, there were six patients (7.9%) with infectious complications compared with 17 patients (19.8%) in the control group (p=0.031). The incidence of the combined endpoint infectious complications and anastomotic leakage was 8 (11%) in the SDD group vs. 22 (26%) in the control group (p=0.014). Multivariate analysis showed that no-SDD, aged above 60 years and diabetes were independent predictors of postoperative complications. Conclusion Perioperative SDD in elective colorectal surgery seems to reduce postoperative surgical complications including infectious complications and anastomotic leakage. Prospective, randomized, placebo-controlled studies are needed to confirm this conclusion.
引用
收藏
页码:1839 / 1844
页数:6
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