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[择期结直肠手术中的机械性肠道准备:常规做法还是必要措施?]

[Mechanical preparation in elective colorectal surgery, a usual practice or a necessity?].

作者信息

Young Tabusso Frank, Celis Zapata Juán, Berrospi Espinoza Francisco, Payet Meza Eduardo, Ruiz Figueroa Eloy

机构信息

Departamento de Cirugía de Abdomen del Instituto de Enfermedades Neoplásicas, Peru.

出版信息

Rev Gastroenterol Peru. 2002 Apr-Jun;22(2):152-8.

Abstract

UNLABELLED

Pre-operative preparation of the colon is carried out with oral and/or intravenous administration of antibiotics and through the mechanical preparation of the colon using various substances to decrease the intraluminal bacterial concentration and remove the larger quantity of fecal material as possible, thus decreasing the risk of anastomosis dehiscence due to an increase in the intraluminal pressure. The role of antibiotics has been completely established while that of mechanical preparation is still questioned. The objective of this study is to assess the actual impact of mechanical preparation on colorectal surgery.

MATERIALS AND METHODS

Forty seven patients who underwent elective colorectal surgery were prospectively evaluated, out of which only 24 had mechanical preparation. We compared variables such as age, sex, preoperative hemoglobin, albumin and leukocyte values, surgery characteristics and type of anastomosis, as well as complications in both groups.

RESULTS

We found a higher incidence of fistulas, dehiscences and general complications in the group undergoing mechanical preparation of the colon.

CONCLUSION

The results show that mechanical preparation of the colon does not provide any benefit and may result in a higher incidence of complications in colorectal surgery.

摘要

未标注

结肠的术前准备通过口服和/或静脉注射抗生素以及使用各种物质对结肠进行机械性准备来进行,以降低肠腔内细菌浓度并尽可能清除大量粪便物质,从而降低因肠腔内压力增加导致吻合口裂开的风险。抗生素的作用已完全明确,而机械性准备的作用仍存在疑问。本研究的目的是评估机械性准备对结直肠手术的实际影响。

材料与方法

对47例行择期结直肠手术的患者进行前瞻性评估,其中仅24例进行了机械性准备。我们比较了两组患者的年龄、性别、术前血红蛋白、白蛋白和白细胞值、手术特征和吻合类型以及并发症等变量。

结果

我们发现结肠机械性准备组的瘘管、裂开和全身并发症发生率更高。

结论

结果表明,结肠机械性准备并无益处,且可能导致结直肠手术并发症发生率更高。

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