University of Oulu

L Koskenvuo, T Lehtonen, S Koskensalo, S Rasilainen, K Klintrup, A Ehrlich, T Pinta, T Scheinin, V Sallinen, Mechanical and oral antibiotic bowel preparation versus no bowel preparation in right and left colectomy: subgroup analysis of MOBILE trial, BJS Open, Volume 5, Issue 2, March 2021, zrab011, https://doi.org/10.1093/bjsopen/zrab011

Mechanical and oral antibiotic bowel preparation versus no bowel preparation in right and left colectomy : subgroup analysis of MOBILE trial

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Author: Koskenvuo, L.1; Lehtonen, T.1; Koskensalo, S.1;
Organizations: 1Department of Gastroenterological Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
2Department of Surgery, Surgical Research Unit, Medical Research Centre, Oulu University Hospital, University of Oulu, Oulu, Finland
3Department of Surgery, Central Hospital of Central Finland, Jyväskylä, Finland
4Department of Surgery, Seinäjoki Central Hospital, Seinäjoki, Finland
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 0.2 MB)
Persistent link: http://urn.fi/urn:nbn:fi-fe2021051830297
Language: English
Published: John Wiley & Sons, 2021
Publish Date: 2021-05-18
Description:

Abstract

Background: In retrospective series, mechanical and oral antibiotic bowel preparation (MOABP) has been reported to reduce surgical-site infections (SSIs) after colectomy compared with no bowel preparation (NBP).

Method: This was a subgroup analysis of a multicentre randomized trial that included patients scheduled for elective colectomy. The MOABP group underwent mechanical bowel preparation, and took 2 g neomycin and 2 g metronidazole orally during the day before surgery. The NBP group did not undergo bowel preparation. Patients were categorized according to the side of resection (right versus left colectomy), and these subgroups compared for postoperative outcomes.

Results: Among 217 patients undergoing right colectomy (106 in MOABP and 111 in NBP group), SSI was detected in seven (7 per cent) and 10 (9 per cent) patients (odds ratio (OR) 0.71, 95 per cent c.i. 0.26 to 1.95; P = 0.510), anastomotic dehiscence in two (2 per cent) and two (2 per cent) patients (OR 1.05, 0.15 to 7.58; P = 1.000), and the mean(s.d.) Comprehensive Complication Index (CCI) score was 9.4(12.9) and 10.5(18.0) (mean difference –1.09; 95 per cent c.i. –5.29 to 3.11; P = 0.608) in the MOABP and NBP groups respectively. Among 164 patients undergoing left colectomy (84 in MOABP and 80 in NBP group), SSI was detected in five (6 per cent) and eight (10 per cent) patients (OR 0.57, 0.18 to 1.82; P = 0.338), anastomotic dehiscence in four (5 per cent) and five (6 per cent) patients (OR 0.75, 0.19 to 2.90; P = 0.742), and the CCI score was 10.2(13.1) and 6.5(11.0) (mean difference 3.68, –0.06 to 7.42; P = 0.053) in the MOABP and NBP groups respectively.

Conclusions: MOABP did not decrease the rate of SSI or complications in patients undergoing either right or left colectomy compared with NBP.

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Series: BJS open
ISSN: 2474-9842
ISSN-E: 2474-9842
ISSN-L: 2474-9842
Volume: 5
Issue: 2
Article number: zrab011
DOI: 10.1093/bjsopen/zrab011
OADOI: https://oadoi.org/10.1093/bjsopen/zrab011
Type of Publication: A1 Journal article – refereed
Field of Science: 3126 Surgery, anesthesiology, intensive care, radiology
Subjects:
Funding: The study was funded by Vatsatautien Tutkimussäätiö Foundation, Mary and Georg Ehrnrooth’s Foundation, the Finnish Cancer Foundation, and Helsinki University Research Funds. The authors declare no conflict of interest.
Copyright information: © The Author(s) 2021. Published by Oxford University Press on behalf of BJS Society Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
  https://creativecommons.org/licenses/by-nc/4.0/