دورية أكاديمية
أعرض في EDS

The Role of Antibiotic Prophylaxis in Anastomotic Leak Prevention during Elective Colorectal Surgery: Systematic Review and Meta-Analysis of Randomized Controlled Trials.

التفاصيل البيبلوغرافية
العنوان: The Role of Antibiotic Prophylaxis in Anastomotic Leak Prevention during Elective Colorectal Surgery: Systematic Review and Meta-Analysis of Randomized Controlled Trials.
المؤلفون: Castagneto-Gissey L; Department of Surgery, Sapienza University of Rome, Viale Regina Elena, 324, 00161 Rome, Italy., Russo MF; Department of Surgery, Sapienza University of Rome, Viale Regina Elena, 324, 00161 Rome, Italy., Casella-Mariolo J; Department of General and Emergency Surgery, Ospedale dei Castelli (NOC), ASL Roma 6, 00072 Rome, Italy., Serao A; Department of General and Emergency Surgery, Ospedale dei Castelli (NOC), ASL Roma 6, 00072 Rome, Italy., Marcellinaro R; Department of General Surgery, S. Eugenio Hospital, 00144 Rome, Italy., D'Andrea V; Department of Surgery, Sapienza University of Rome, Viale Regina Elena, 324, 00161 Rome, Italy., Carlini M; Department of General Surgery, S. Eugenio Hospital, 00144 Rome, Italy., Casella G; Department of Surgery, Sapienza University of Rome, Viale Regina Elena, 324, 00161 Rome, Italy.
المصدر: Antibiotics (Basel, Switzerland) [Antibiotics (Basel)] 2023 Feb 16; Vol. 12 (2). Date of Electronic Publication: 2023 Feb 16.
نوع المنشور: Journal Article; Review
اللغة: English
بيانات الدورية: Publisher: MDPI AG Country of Publication: Switzerland NLM ID: 101637404 Publication Model: Electronic Cited Medium: Print ISSN: 2079-6382 (Print) Linking ISSN: 20796382 NLM ISO Abbreviation: Antibiotics (Basel) Subsets: PubMed not MEDLINE
أسماء مطبوعة: Original Publication: Basel, Switzerland : MDPI AG, 2012-
مستخلص: Introduction : Despite several perioperative care advancements and innovations in surgical procedures and technologies, the incidence rate of anastomotic leaks (ALs) after colorectal surgery has not substantially decreased. Gut microbiota can play a critical role in the healing process of anastomotic tissue and alterations in its composition may be largely to blame for anastomotic insufficiency. The use of specific antibiotics for preoperative large bowel decontamination could significantly influence the rate of ALs. The aim of this study was to systematically assess the various antibiotic prophylactic regimen strategies for primary prevention of ALs during colorectal surgery, in view of the available evidence. Methods : A systematic review of the literature was conducted, and randomized clinical trials (RCTs) analyzing prophylactic antibiotic bowel preparation in colorectal surgery were included. PubMed, Embase, the Web of Science Core Collection, and the Cochrane Central Register of Controlled Trials were searched from inception through to 30 November 2022. The methodological quality of the included trials was evaluated. The primary outcome was AL rate; secondary outcomes were superficial/deep surgical site infections (SSIs). The PRISMA guidelines were used to carry out the present systematic review. Results: Thirteen RCTs published between 1977 and 2022, with a total of 4334 patients were included in the meta-analysis. Antibiotic prophylaxis was administered orally in 11/13 studies and intravenously in 2 studies. Patients randomly assigned to antibiotic prophylaxis, regardless of the regimen, had a reduced risk of ALs ( p = 0.003) compared to mechanical bowel preparation (MBP) alone. The use of antibiotic prophylaxis was also more effective in significantly reducing SSIs ( p < 0.001). Conclusions: The evidence points to an advantage of oral antibiotic prophylaxis in terms of AL rate, a significant contributor to perioperative morbidity, mortality, and rising healthcare expenditures. In light of such results, the use of antibiotic prophylaxis should be strongly encouraged prior to colorectal surgery.
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فهرسة مساهمة: Keywords: anastomotic leak; antibiotics; colorectal surgery; prophylaxis; surgical site infection
تواريخ الأحداث: Date Created: 20230225 Latest Revision: 20230228
رمز التحديث: 20231215
مُعرف محوري في PubMed: PMC9951989
DOI: 10.3390/antibiotics12020397
PMID: 36830306
قاعدة البيانات: MEDLINE
الوصف
تدمد:2079-6382
DOI:10.3390/antibiotics12020397