Mechanical and oral antibiotic bowel preparation versus no bowel preparation in right and left colectomy: subgroup analysis of MOBILE trial

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Koskenvuo , L , Lehtonen , T , Koskensalo , S , Rasilainen , S , Klintrup , K , Ehrlich , A , Pinta , T , Scheinin , T & Sallinen , V 2021 , ' Mechanical and oral antibiotic bowel preparation versus no bowel preparation in right and left colectomy: subgroup analysis of MOBILE trial ' , BJS open , vol. 5 , no. 2 , 011 . https://doi.org/10.1093/bjsopen/zrab011

Title: Mechanical and oral antibiotic bowel preparation versus no bowel preparation in right and left colectomy: subgroup analysis of MOBILE trial
Author: Koskenvuo, L; Lehtonen, T; Koskensalo, S; Rasilainen, S; Klintrup, K; Ehrlich, A; Pinta, T; Scheinin, T; Sallinen, V
Contributor organization: HUS Abdominal Center
II kirurgian klinikka
Department of Surgery
Clinicum
University of Helsinki
Helsinki University Hospital Area
IV kirurgian klinikka
Doctoral Programme in Clinical Research
Pertti Panula / Principal Investigator
Date: 2021-03
Language: eng
Number of pages: 7
Belongs to series: BJS open
ISSN: 2044-6055
DOI: https://doi.org/10.1093/bjsopen/zrab011
URI: http://hdl.handle.net/10138/332430
Abstract: In retrospective series, mechanical and oral antibiotic bowel preparation (MOABP) has been reported to reduce surgical-site infections (SSIs) after colectomy compared with no bowel preparation (NBP).This was a subgroup analysis of a multicentre randomized trial that included patients scheduled for elective colectomy. The MOABP group underwent mechanical bowel preparation, and took 2 g neomycin and 2 g metronidazole orally during the day before surgery. The NBP group did not undergo bowel preparation. Patients were categorized according to the side of resection (right versus left colectomy), and these subgroups compared for postoperative outcomes.Among 217 patients undergoing right colectomy (106 in MOABP and 111 in NBP group), SSI was detected in seven (7 per cent) and 10 (9 per cent) patients (odds ratio (OR) 0.71, 95 per cent c.i. 0.26 to 1.95; P = 0.510), anastomotic dehiscence in two (2 per cent) and two (2 per cent) patients (OR 1.05, 0.15 to 7.58; P = 1.000), and the mean(s.d.) Comprehensive Complication Index (CCI) score was 9.4(12.9) and 10.5(18.0) (mean difference –1.09; 95 per cent c.i. –5.29 to 3.11; P = 0.608) in the MOABP and NBP groups respectively. Among 164 patients undergoing left colectomy (84 in MOABP and 80 in NBP group), SSI was detected in five (6 per cent) and eight (10 per cent) patients (OR 0.57, 0.18 to 1.82; P = 0.338), anastomotic dehiscence in four (5 per cent) and five (6 per cent) patients (OR 0.75, 0.19 to 2.90; P = 0.742), and the CCI score was 10.2(13.1) and 6.5(11.0) (mean difference 3.68, –0.06 to 7.42; P = 0.053) in the MOABP and NBP groups respectively.MOABP did not decrease the rate of SSI or complications in patients undergoing either right or left colectomy compared with NBP.Background: In retrospective series, mechanical and oral antibiotic bowel preparation (MOABP) has been reported to reduce surgical-site infections (SSIs) after colectomy compared with no bowel preparation (NBP). Method: This was a subgroup analysis of a multicentre randomized trial that included patients scheduled for elective colectomy. The MOABP group underwent mechanical bowel preparation, and took 2 g neomycin and 2 g metronidazole orally during the day before surgery. The NBP group did not undergo bowel preparation. Patients were categorized according to the side of resection (right versus left colectomy), and these subgroups compared for postoperative outcomes. Results: Among 217 patients undergoing right colectomy (106 in MOABP and 111 in NBP group), SSI was detected in seven (7 per cent) and 10 (9 per cent) patients (odds ratio (OR) 0.71, 95 per cent c.i. 0.26 to 1.95; P=0.510), anastomotic dehiscence in two (2 per cent) and two (2 per cent) patients (OR 1.05, 0.15 to 7.58; P=1.000), and the mean(s.d.) Comprehensive Complication Index (CCI) score was 9.4(12.9) and 10.5(18.0) (mean difference -1.09; 95 per cent c.i. -5.29 to 3.11; P=0.608) in the MOABP and NBP groups respectively. Among 164 patients undergoing left colectomy (84 in MOABP and 80 in NBP group), SSI was detected in five (6 per cent) and eight (10 per cent) patients (OR 0.57, 0.18 to 1.82; P=0.338), anastomotic dehiscence in four (5 per cent) and five (6 per cent) patients (OR 0.75, 0.19 to 2.90; P=0.742), and the CCI score was 10.2(13.1) and 6.5(11.0) (mean difference 3.68, -0.06 to 7.42; P=0.053) in the MOABP and NBP groups respectively. Conclusions: MOABP did not decrease the rate of SSI or complications in patients undergoing either right or left colectomy compared with NBP.
Description: zrab011
Subject: 3126 Surgery, anesthesiology, intensive care, radiology
SURGICAL SITE INFECTION
SYSTEMIC ANTIBIOTICS
COLORECTAL SURGERY
ENHANCED RECOVERY
AMERICAN SOCIETY
ANASTOMOTIC LEAK
PREVENTION
Peer reviewed: Yes
Rights: cc_by_nc
Usage restriction: openAccess
Self-archived version: publishedVersion


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