Selective Decontamination with Oral Antibiotics in Colorectal Surgery: 90-day Reintervention Rates and Long-term...

Area of Science:

• Colorectal Surgery
• Surgical Oncology
• Infectious Disease Prevention

Background:

• Oral antibiotics (OAB) are used in colorectal surgery to decrease surgical site infections (SSIs) and anastomotic leakage.
• Limited data exists on the long-term effects of OAB, including reintervention rates and 5-year oncological outcomes.

Purpose of the Study:

• To evaluate the long-term effectiveness of perioperative Selective Decontamination of the Digestive Tract (SDD) in colorectal cancer surgery.
• To assess the impact of SDD on anastomotic leakage, infectious complications, reinterventions, and 5-year survival rates.

Main Methods:

• A study involving 455 patients undergoing colorectal cancer surgery, comparing SDD (228 patients) with a control group (227 patients).
• Primary outcome: anastomotic leakage within 90 days. Secondary outcomes: infectious complications, reinterventions, readmissions, hospital stay, and 5-year overall and disease-free survival.
• Statistical analyses included univariate, multivariate, and Kaplan-Meier survival analysis.

Main Results:

• No significant difference in anastomotic leakage rates between SDD and control groups (6.6% vs. 9.7%).
• SDD significantly reduced infectious complications (15.4% vs. 28.2%) and reinterventions (8.8% vs. 16.3%) within 90 days.
• Multivariable analysis confirmed SDD's effectiveness in reducing 90-day infectious complications and reinterventions; no difference in 5-year survival outcomes.

Conclusions:

• Selective Decontamination of the Digestive Tract (SDD) effectively reduces postoperative infectious complications and reinterventions within 90 days in colorectal surgery.
• SDD is recommended as a standard oral antibiotic regimen for elective colorectal surgery.
• The study found no impact of SDD on 5-year overall or disease-free survival.