Randomized Controlled Trial on the Necessity of Chemical Cleaning as Preoperative Preparation for Colorectal Cancer Surgery

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The use of preoperative oral antibiotics for the preparation of elective colorectal surgery remains controversial. We examined the necessity of chemical preparation using oral antibiotics compared with mechanical preparation, to achieve the further reduction of infection rates in colorectal resection. Consecutive 91 patients were included in this prospective clinical trial of colon preparation. 45 patients received mechanical preparation alone with the polyethylene glycol lavage solution (group A), while 46 patients received mechanical preparation and chemical bowel preparation with 1.5g Kanamycin for 3 days orally before surgery (group B). Cefotiam hydrochloride was administered for 3 consecutive days after surgery in both groups. Specimens for culture were obtained pre-, intra- and post-operatively. In the specimens of intraoperative colonic mucosal swabs, Escherichia coli (E. coli) was significantly less cultured in group B than in group A. Postoperative diarrhea was observed in 7 patients of group A (15.5%) and in 20 patients of group B (43.5%) (p<0.05). The surgical site infection (SSI) rate was 20.0% in group A and 36.9% in group B (p=0.1041). Although there was no significant difference, SSI rate tended to be higher in group B than in group A. In conclusion, chemical preparation with oral intake of 1,500mg Kanamycin for 3 days before surgery did not add any advantages to mechanical preparation and is considered unnecessary to perform colorectal surgery.
獨協医科大学の論文

Randomized Controlled Trial on the Necessity of Chemical Cleaning as Preoperative Preparation for Colorectal Cancer Surgery

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