Kumar Anjali S, Kelleher Deirdre C, Sigle Gavin W
Section of Colon and Rectal Surgery, Department of Surgery, MedStar Washington Hospital Center, Washington, District of Columbia ; Department of Surgery, Georgetown University, Washington, District of Columbia.
Section of Colon and Rectal Surgery, Department of Surgery, MedStar Washington Hospital Center, Washington, District of Columbia ; Department of Surgery, Weill Cornell Medical Center, New York Presbyterian Hospital, New York, New York.
Clin Colon Rectal Surg. 2013 Sep;26(3):146-52. doi: 10.1055/s-0033-1351129.
Mechanical bowel preps were initially thought to decrease the bacterial load of the colon and therefore decrease infection. Traditional bowel preps include osmotic, laxative, and combination regimen. Data demonstrate that mechanical bowel preps are generally equivalent; however, the addition of oral antibiotics may further reduce the risk of infection. Recent data suggest that mechanical bowel preparations may not be necessary, and that dietary restrictions before surgery may also be obsolete. In this review, the authors address the types of mechanical bowel preparations (MBPs), differences in outcomes between MBPs, the role of oral antibiosis and enemas, the benefits of no MBP, and dietary preparations for elective colon and rectal surgery.
机械性肠道准备最初被认为可降低结肠细菌载量,从而减少感染。传统的肠道准备包括渗透性、缓泻剂及联合方案。数据表明,机械性肠道准备总体效果相当;然而,加用口服抗生素可能进一步降低感染风险。近期数据显示,机械性肠道准备可能并非必要,术前的饮食限制或许也已过时。在本综述中,作者探讨了机械性肠道准备(MBP)的类型、不同MBP之间的结局差异、口服抗生素及灌肠的作用、不进行MBP的益处以及择期结肠和直肠手术的饮食准备。