Department of Colon and Rectal Surgery, Sunlin Hospital, Pohang, Korea.
J Korean Med Sci. 2010 Mar;25(3):429-34. doi: 10.3346/jkms.2010.25.3.429. Epub 2010 Feb 17.
This study examined infectious outcomes in elective colorectal cancer surgery between cefotetan alone or conventional triple antibiotics. From January to December 2007, 461 consecutive primary colorectal cancer patients underwent elective surgery. Group A contained 225 patients who received conventional triple antibiotics (cephalosporin, aminoglycoside and metronidazole) for prophylaxis, and group B contained 236 patients who received cefotetan alone for prophylaxis. Treatment failure was defined as the presence of postoperative infection including surgical-site infection (SSI), anastomotic leakage, and pneumonia or urinary tract infection. The two groups were similar in terms of demographics, American Society of Anesthesiologists (ASA) score, tumour location, stage, surgical approach (conventional open vs. laparoscopy-assisted), and type of operation. The treatment failure rates were 3.1% in Group A and 3.4% in Group B (absolute difference, -0.3%; 95% confidence interval [CI], 0.39 to 3.07, P=0.866), with SSI being the most common reason for failure in both groups (2.7% in Group A and 3.0% in Group B [absolute difference, -0.3%; 95% CI, 0.37 to 3.37, P=0.846]). Cefotetan alone is as effective as triple antibiotics for prophylaxis in primary colorectal cancer patients undergoing elective surgery.
本研究旨在比较头孢替坦单药与传统三联抗生素在择期结直肠癌手术中的感染结局。2007 年 1 月至 12 月,连续纳入 461 例择期行结直肠癌根治术的患者。A 组 225 例患者接受传统三联抗生素(头孢菌素、氨基糖苷类和甲硝唑)预防感染,B 组 236 例患者接受头孢替坦单药预防感染。治疗失败定义为术后感染,包括手术部位感染(SSI)、吻合口漏、肺炎或尿路感染。两组患者在人口统计学特征、美国麻醉医师协会(ASA)评分、肿瘤位置、分期、手术方式(传统开腹与腹腔镜辅助)和手术类型方面均相似。A 组和 B 组的治疗失败率分别为 3.1%和 3.4%(绝对差值,-0.3%;95%置信区间,0.39 至 3.07,P=0.866),两组中 SSI 均是最常见的失败原因(A 组 2.7%,B 组 3.0%[绝对差值,-0.3%;95%置信区间,0.37 至 3.37,P=0.846])。在择期结直肠癌根治术患者中,头孢替坦单药与传统三联抗生素预防效果相当。