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Mechanical bowel preparation combined with oral antibiotics in colorectal cancer surgery: a nationwide population-based study

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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Background

The guidelines for reducing surgical site infection in colorectal surgery recommend mechanical bowel preparation with oral antibiotics; however, this recommendation remains controversial. This study aimed to reveal the effect of oral antibiotics combined with mechanical bowel preparation in colorectal surgery.

Methods

This study was a nationwide population-based retrospective study. Data between January 1, 2016, and December 31, 2018, from the Korean National Health Insurance Service database were analyzed. Patients who underwent elective colorectal cancer surgery were included.

Results

A total of 20,740 patients were finally included, comprising 14,554 (70.2%) who underwent mechanical bowel preparation alone and 6186 (29.8%) who underwent mechanical bowel preparation with oral antibiotics. The mechanical bowel preparation alone group was older than the mechanical bowel preparation with oral antibiotics group (65.7 ± 11.9 vs. 64.7 ± 11.8 years, p < 0.001). Rectal cancer patients and patients who underwent open surgery were more likely to receive mechanical bowel preparation with oral antibiotics. Patients who underwent mechanical bowel preparation with oral antibiotics demonstrated lower surgical-site infection rate (2.9% vs. 9.4%, p < 0.001), shorter hospital stay (11.7 ± 5.5 vs. 13.5 ± 7.3 days, p < 0.001), and lower medical cost (US$7414 ± 2762 vs. US$7791 ± 3235, p < 0.001) than those who underwent mechanical bowel preparation alone. The 30-day readmission rates and mortality were not significantly different.

Conclusions

The use of mechanical bowel preparation with oral antibiotics reduces surgical site infection, hospital stay, and medical cost in colorectal cancer surgery.

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Authors and Affiliations

  1. Department of Surgery, College of Medicine, Hanyang University, 222-1 Wangsimni-ro, Seongdong-gu, Seoul, 04763, Republic of Korea

    Jun Ho Lee, Byung Kyu Ahn & Kang Hong Lee

  2. Biostatistical Consulting and Research Lab, Medical Research Collaborating Center, Hanyang University, Seoul, Republic of Korea

    Jiin Ryu

Authors
  1. Jun Ho Lee
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  2. Byung Kyu Ahn
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  4. Kang Hong Lee
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Contributions

Jun Ho Lee, Byung Kyu Ahn and Kang Hong Lee conceived and designed the study. Jiin Ryu assembled and analyzed data. Jun Ho Lee and Byung Kyu Ahn interpreted data. Jun Ho Lee and Kang Hong Lee drafted the article. All authors approved the final manuscript.

Corresponding author

Correspondence to Kang Hong Lee.

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Conflict of interest

The authors declare that they have no conflict of interest.

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Lee, J.H., Ahn, B.K., Ryu, J. et al. Mechanical bowel preparation combined with oral antibiotics in colorectal cancer surgery: a nationwide population-based study. Int J Colorectal Dis 36, 1929–1935 (2021). https://doi.org/10.1007/s00384-021-03967-x

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  • DOI: https://doi.org/10.1007/s00384-021-03967-x

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