Preoperative mechanical bowel preparation combined with oral antibacterials in the prevention of complications of surgery for rectal and rectosigmoid junction cancer

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Abstract

Aim: To evaluate the efficacy of mechanical bowel preparation (MBP) combined with oral antibacterials for the prevention of postoperative complications when preparing a patient for anterior rectal resection.

Materials and methods: We analyzed shortterm results in 77 patients who had undergone anterior rectal resection for rectal and rectosigmoid junction cancer. Forty five (45) patients were prepared for surgery only with MBP. In 32 patients, in addition to MBP, oral antibacterial agents ciprofloxacin and metronidazole were used preoperatively.

Results: The overall rate of postoperative complications was 6.25% (2/32 patients) in the group of combined preparation for surgery and 15.5% (7/45) in the group using only MBP. Surgical wound infection occurred in 1 patient in the combined preparation group and in 4 patients in the MBP only group. There was no anastomotic leak in the combined preparation group, whereas in the MBP only group, anastomotic leak occurred in 2 patients.

Conclusion: Combined use of oral antibacterials and MBP before anterior rectal resection makes it possible to achieve an extremely low rate of the colorectal anastomosis leak. Further studies into the efficacy of this preparation regimen are needed, along with their discussion in the professional communities.

About the authors

Yu. V. Ivanov

Federal Scientific and Clinical Center for Specialized Types of Medical Care and Medical Technologies;
A.I. Evdokimov Moscow State University of Medicine and Dentistry

Email: ivanovkb83@yandex.ru
ORCID iD: 0000-0001-6209-4194

Yuri V. Ivanov – MD, PhD, Professor, Head of Department of Surgery Federal Scientific and Clinical Center for Specialized Types of Medical Care and Medical Technologies; Chief Research Fellow, Laboratory of Minimally Invasive Surgery A.I. Evdokimov Moscow State University of Medicine and Dentistry

28 Orekhovyy bul'var, Moscow, 115682, 

20–1 Delegatskaya ul., Moscow, 127473

Russian Federation

A. V. Smirnov

Federal Scientific and Clinical Center for Specialized Types of Medical Care and Medical Technologies

Author for correspondence.
Email: alvsmirnov@mail.ru
ORCID iD: 0000-0003-3897-8306

Alexander V. Smirnov – MD, PhD, Surgeon, Department of Surgery

28 Orekhovyy bul'var, Moscow, 115682

 

Russian Federation

A. V. Vinokurov

Federal Scientific and Clinical Center for Specialized Types of Medical Care and Medical Technologies

Email: vinokuroff.sasha2015@yandex.ru
ORCID iD: 0000-0001-8026-1216

Aleksandr V. Vinokurov – Resident, Chair of Surgery, Academy of Postgraduate Education

28 Orekhovyy bul'var, Moscow, 115682

Russian Federation

A. I. Zlobin

Federal Scientific and Clinical Center for Specialized Types of Medical Care and Medical Technologies

Email: fake@neicon.ru

Alexander I. Zlobin – MD, PhD, Surgeon, Department of Surgery

28 Orekhovyy bul'var, Moscow, 115682

Russian Federation

V. R. Stankevich

Federal Scientific and Clinical Center for Specialized Types of Medical Care and Medical Technologies

Email: v-stankevich@yandex.ru
ORCID iD: 0000-0002-8620-8755

Vladimir R. Stankevich – Surgeon, Department of Surgery

28 Orekhovyy bul'var, Moscow, 115682

Russian Federation

E. S. Danilina

Federal Scientific and Clinical Center for Specialized Types of Medical Care and Medical Technologies

Email: danilina.katja@bk.ru
ORCID iD: 0000-0002-2466-3795

Ekaterina S. Danilina – Surgeon, Department of Surgery; Senior Laboratory Assistant, Chair of Surgery, Academy of Postgraduate Education

28 Orekhovyy bul'var, Moscow, 115682

Russian Federation

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Copyright (c) 2021 Ivanov Y.V., Smirnov A.V., Vinokurov A.V., Zlobin A.I., Stankevich V.R., Danilina E.S.

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