Nakanishi Ryo, Ozawa Heita, Toyota Naoyuki, Mise Minori, Fujita Shin
Department of Colorectal Surgery, Tochigi Cancer Center, 4-9-13 Yohnan, Utsunomiya 320-0834, Tochigi, Japan.
Medicina (Kaunas). 2024 Nov 29;60(12):1970. doi: 10.3390/medicina60121970.
Recent findings suggest that combining mechanical bowel preparation (MBP) and preoperative oral antibiotics (OAs) decreases the risk of incisional surgical site infections (iSSIs) in colorectal surgery; however, this finding remains controversial. This study examined the efficacy of OAs and MBP in colorectal surgery using propensity score matching (PSM). : Between January 2015 and December 2020, 559 patients with colorectal tumors underwent MBP followed by colorectal surgery. The multivariate analysis used a COX proportional hazards model to extract risk factors for iSSI. PSM was performed to balance the impact of potential co-factors of OAs with MBP (OA) and MBP alone (non-OA) on superficial SSI incidence. : The multivariate analysis identified non-OA use as an independent risk factor for iSSIs (odds ratio [OR]: 2.44, 95% confidence interval [CI]: 1.22-4.88, = 0.0112). After matching the cohort, both OA and non-OA groups were divided into 217 cases each. The incisional SSI rate was significantly lower in the OA group ( = 338) than in the non-OA group (1.61% vs. 5.07%; OR 3.4; 95% CI; 0.123-0.707; = 0.0062). : This study revealed that OAs with MBP markedly reduced SSI rates. OAs with MBP should be adopted in colorectal surgery.
近期研究结果表明,在结直肠手术中联合机械性肠道准备(MBP)和术前口服抗生素(OAs)可降低手术切口部位感染(iSSIs)的风险;然而,这一发现仍存在争议。本研究采用倾向评分匹配(PSM)方法探讨了OAs和MBP在结直肠手术中的疗效。:2015年1月至2020年12月期间,559例结直肠肿瘤患者接受了MBP,随后进行了结直肠手术。多变量分析使用COX比例风险模型提取iSSI的危险因素。进行PSM以平衡OAs与MBP(OA组)和单独MBP(非OA组)的潜在共同因素对浅表手术切口感染发生率的影响。:多变量分析确定未使用OAs是iSSIs的独立危险因素(比值比[OR]:2.44,95%置信区间[CI]:1.22 - 4.88,P = 0.0112)。对队列进行匹配后,OA组和非OA组各分为217例。OA组的手术切口感染率显著低于非OA组(1.61%对5.07%;OR 3.4;95% CI:0.123 - 0.707;P = 0.0062)。:本研究表明,MBP联合OAs可显著降低手术切口感染率。结直肠手术应采用MBP联合OAs。