Preoperative Oral Antibiotics Preparation is Associated With Improved 30-day Outcomes in Elective Colectomy for Ulcerative Colitis.

IF 1 4区 医学 Q3 SURGERY
Renxi Li, Susan Kartiko
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引用次数: 0

Abstract

Background: Ulcerative colitis (UC) is characterized by colonic involvement, where the 10-year risk of colectomy remains high at about 20%. The use of preoperative oral antibiotic preparation (OAP) in colectomy remains a subject of debate and there was limited evidence for UC patients. This study aimed to retrospectively investigate the relationship between OAP and 30-day outcomes following elective colectomy in UC patients using a multi-institutional national dataset.

Methods: Patients with UC as the primary indication for colectomy were selected from the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database from 2013 to 2022. Thirty-day postoperative outcomes were compared by multivariable logistic regression, where demographics, baseline characteristics, preoperative preparation, and operative approaches were adjusted.

Results: Among 6075 patients who underwent elective colectomy for UC, 3193 (52.56%) of them received preoperative OAP. Patients with OAP had lower cardiac complications (aOR = 0.358, 95 CI = 0.137-0.932, P = 0.04), pulmonary complications (aOR = 0.686, 95 CI = 0.494-0.952, P = 0.02), bleeding requiring transfusion (aOR = 0.738, 95 CI = 0.601-0.906, P < 0.01), wound complications (aOR = 0.626, 95 CI = 0.527-0.743, P < 0.01), prolonged postoperative nothing by mouth (NPO) or nasogastric tube (NGT) use (aOR = 0.781, 95 CI = 0.678-0.901, P < 0.01), and 30-day readmission (aOR = 0.811, 95 CI = 0.676-0.972, P = 0.02). Moreover, patients with OAP had shorter length of stay (P < 0.01).

Conclusion: The use of OAP in elective UC colectomy was shown to have additional benefits beyond surgical site infections. Further large-scale randomized trials may be needed to determine the cause and effect of these observations.

术前口服抗生素准备与溃疡性结肠炎择期结肠切除术30天预后改善相关
背景:溃疡性结肠炎(UC)的特点是累及结肠,结肠切除术的10年风险仍然很高,约为20%。结肠切除术中术前口服抗生素制剂(OAP)的使用仍然是一个有争议的话题,UC患者的证据有限。本研究旨在使用多机构国家数据集回顾性调查UC患者择期结肠切除术后OAP与30天预后之间的关系。方法:从2013年至2022年美国外科医师学会国家手术质量改进计划(ACS-NSQIP)数据库中选择以UC为结肠切除术主要指征的患者。术后30天的结果通过多变量logistic回归进行比较,其中调整了人口统计学、基线特征、术前准备和手术入路。结果:6075例UC择期结肠切除术患者中,3193例(52.56%)接受术前OAP治疗。养老金患者心脏并发症较低(aOR = 0.358, 95 CI = 0.137 - -0.932, P = 0.04),肺部并发症(优势比= 0.686,95 CI = 0.494 - -0.952, P = 0.02),出血需要输血(优势比= 0.738,95 CI = 0.601 - -0.906, P < 0.01),伤口并发症(优势比= 0.626,95 CI = 0.527 - -0.743, P < 0.01),术后没有延长了嘴(NPO)或鼻胃管(NGT)使用(优势比= 0.781,95 CI = 0.678 - -0.901, P < 0.01), 30天重新接纳(优势比= 0.811,95 CI = 0.676 - -0.972,P = 0.02)。此外,OAP患者的住院时间较短(P < 0.01)。结论:在选择性UC结肠切除术中使用OAP被证明具有手术部位感染以外的额外益处。可能需要进一步的大规模随机试验来确定这些观察结果的因果关系。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
American Surgeon
American Surgeon 医学-外科
CiteScore
1.40
自引率
0.00%
发文量
623
期刊介绍: The American Surgeon is a monthly peer-reviewed publication published by the Southeastern Surgical Congress. Its area of concentration is clinical general surgery, as defined by the content areas of the American Board of Surgery: alimentary tract (including bariatric surgery), abdomen and its contents, breast, skin and soft tissue, endocrine system, solid organ transplantation, pediatric surgery, surgical critical care, surgical oncology (including head and neck surgery), trauma and emergency surgery, and vascular surgery.
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