Department of Colorectal Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
World J Surg Oncol. 2018 Jul 9;16(1):134. doi: 10.1186/s12957-018-1440-4.
The optimal preoperative bowel preparation for colorectal surgery remains controversial. However, recent studies have established that bowel preparation varies significantly among countries and even surgeons at the same institution. This survey aimed to obtain information on the current practice patterns of bowel preparation for colorectal surgery in China.
A paper-based survey was circulated to the members of the Chinese Society of Colorectal Cancer (CSCC). The survey responses were collected and analyzed. Statistical analysis was performed for all the categorical variables according to the responses to individual questions.
Three hundred forty-one members completed the questionnaire. Regarding surgical practice, 203 (59.5%) performed > 50% of the colorectal operations laparoscopically or robotically; the use of mechanical bowel preparation (MBP) alone was significantly higher (63.5 vs 31.9%; P < 0.001). The respondents who performed > 200 colonic or rectal resections provided significantly more MBP alone (79.6 vs 39.1%, P < 0.001; 76.6 vs 43.2%, P < 0.001; respectively). Among hospitals with fewer than 500 beds, 52.4% of the respondents used MBP + oral antibiotics preparation (OAP) + enema, a significantly higher percentage than the respondents of hospitals with more than 500 beds (P < 0.001). Nearly 40% of the respondents prescribed OAP in regimens; meanwhile, 74.8% prescribed preoperative intravenous antibiotics.
The study demonstrates considerable variation among members from the CSCC. These findings should be considered when developing multicenter trials and to provide more definitive answers.
结直肠手术的最佳术前肠道准备仍存在争议。然而,最近的研究已经证实,肠道准备在不同国家甚至同一机构的外科医生之间存在显著差异。本调查旨在获取中国结直肠外科肠道准备现状的信息。
采用纸质问卷对中国结直肠癌学会(CSCC)的成员进行调查。收集并分析调查结果。根据对个别问题的回答,对所有分类变量进行统计分析。
341 名成员完成了问卷。关于手术实践,203 名(59.5%)进行了>50%的腹腔镜或机器人结直肠手术;单独使用机械肠道准备(MBP)的比例明显更高(63.5%比 31.9%;P<0.001)。进行>200 例结肠或直肠切除术的受访者单独提供的 MBP 明显更多(79.6%比 39.1%,P<0.001;76.6%比 43.2%,P<0.001;分别)。在少于 500 张床位的医院中,52.4%的受访者使用 MBP+口服抗生素准备(OAP)+灌肠,这一比例明显高于拥有超过 500 张床位的受访者(P<0.001)。近 40%的受访者规定了 OAP 的方案;同时,74.8%的受访者在术前使用静脉抗生素。
本研究表明 CSCC 成员之间存在相当大的差异。在制定多中心试验和提供更明确的答案时,应考虑这些发现。