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

Area of Science:

• Colorectal Surgery
• Surgical Oncology
• Infectious Disease Prevention

Background:

• The role of mechanical bowel preparation (MBP) and oral antibiotic prophylaxis (OABP) in preventing postoperative complications after colorectal surgery remains debated.
• A prospective randomized trial was conducted to evaluate the efficacy of OABP when administered alongside MBP.

Purpose of the Study:

• To determine the impact of adding OABP to MBP on reducing surgical-site infections (SSI) and postoperative ileus.
• To assess secondary outcomes including anastomotic leak (AL), mortality, and 30-day hospital readmission rates.

Main Methods:

• A multicentre, prospective, randomized, assessor-blinded study involving patients undergoing elective colorectal surgery.
• Patients were randomized into two groups: MBP with OABP (OABP+) and MBP without OABP (OABP-).
• Primary endpoints were SSI and postoperative ileus; secondary endpoints included AL, mortality, and readmission.

Main Results:

• The OABP+ group showed significantly lower rates of SSI (3.2% vs. 9.8%, P=0.001) and AL (1.6% vs. 4.7%, P=0.02) compared to the OABP- group.
• No significant difference was observed in the incidence of postoperative ileus between the groups.
• Mortality and hospital readmission rates within 30 days did not differ significantly between the OABP+ and OABP- groups.

Conclusions:

• The addition of OABP to MBP significantly reduces the incidence of SSI and AL in patients undergoing colorectal surgery with anastomosis.
• Routine use of OABP in conjunction with MBP is recommended to improve surgical outcomes and patient safety.