Systemic versus Oral and Systemic Antibiotic Prophylaxis (SOAP) study in colorectal surgery: prospective randomized multicentre trial

Author:

Papp G1ORCID,Saftics Gy1,Szabó B E1,Baracs J2,Vereczkei A2,Kollár D3,Oláh A3,Mészáros P4,Dubóczki Zs4,Bursics A1

Affiliation:

1. Department of General Surgery and Surgical Oncology, Uzsoki Hospital, Budapest, Hungary

2. Department of Surgery, University of Pécs Clinical Centre, Pécs, Hungary

3. Department of General Surgery, Petz Aladár Teaching Hospital, Győr, Hungary

4. Department of Visceral Surgery, National Institute of Oncology, Centre of Oncosurgery, Budapest, Hungary

Abstract

Abstract Background There is no consensus regarding the role of mechanical bowel preparation (MBP) and oral antibiotic prophylaxis (OABP) in reducing postoperative complications in colorectal surgery. The aim of this study was to examine the effect of OABP given in addition to MBP in the setting of a prospective randomized trial. Methods Patients awaiting elective colorectal surgery in four Hungarian colorectal centres were included in this multicentre, prospective, randomized, assessor-blinded study. Patients were randomized to receive MBP with or without OABP (OABP+ and OABP– groups respectively). The primary endpoints were surgical-site infection (SSI) and postoperative ileus. Secondary endpoints were anastomotic leak, mortality, and hospital readmission within 30 days. Results Of 839 patients assessed for eligibility between November 2016 and June 2018, 600 were randomized and 529 were analysed. Trial participation was discontinued owing to adverse events in seven patients in the OABP+ group (2.3 per cent). SSI occurred in eight patients (3.2 per cent) in the OABP+ and 27 (9.8 per cent) in the OABP– group (P = 0.001). The incidence of postoperative ileus did not differ between groups. Anastomotic leakage occurred in four patients (1.6 per cent) in the OABP+ and 13 (4.7 per cent) in the OABP– (P = 0.02) group. There were no differences in hospital readmission (12 (4.7 per cent) versus 10 (3.6 per cent); P = 0.25) or mortality (3 (1.2 per cent) versus 4 (1.4 per cent); P = 0.39). Conclusion OABP given with MBP reduced the rate of SSI and AL after colorectal surgery with anastomosis, therefore routine use of OABP is recommended.

Publisher

Oxford University Press (OUP)

Subject

Surgery

Reference35 articles.

1. A European survey of bowel preparation in colorectal surgery;Devane;Colorectal Dis,2017

2. Mechanical bowel preparation for elective colorectal surgery;Güenaga;Cochrane Database Syst Rev,2011

3. Guidelines for perioperative care in elective colorectal surgery: Enhanced Recovery After Surgery (ERAS®) Society recommendations: 2018;Gustafsson;World J Surg,2019

4. Efficacy of preoperative antimicrobial preparation of the bowel;Nichols;Ann Surg,1972

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