Impact of bowel preparation on surgical site infections and anastomotic leakage after elective colon resection: results of aretrospective study with 260 patients

Abstract

Bowel preparation is performed in different ways prior to elective colon surgery. The aim of this study was to evaluate the influence of different bowel preparations on surgical site infections, anastomotic leakage and postoperative ileus in elective colon surgery. Aretrospective analysis was performed in this institution with patients who underwent elective colon surgery from 2013-2019. Patients received different types of bowel preparation and were divided into three different groups: no mechanical bowel preparation (MBP-), mechanical bowel preparation without oral antibiotics (MBP+/OABP-) and with oral antibiotics (MBP+/OABP+). These groups were compared with respect to surgical site infections, anastomotic leakage, and the duration of postoperative ileus. A total of 260 consecutive patients (MBP- n = 48, MBP+/OABP- n = 145 and MBP+/OABP+ n = 67) were analyzed. With acombined bowel preparation, the rate of surgical site infections could be considerably reduced (MBP- vs. MBP+/OABP+ 16.7% vs. 4.5%, p = 0.05). The type of bowel preparation was identified as the only factor associated with the incidence of surgical site infections; however, the type of bowel preparation did not have an influence on the rate of anastomotic leakages or duration of postoperative ileus in univariate and multivariate analyses. Bowel preparation with mechanical cleansing and oral antibiotics (MBP+/OABP+) is beneficial due to asignificant reduction of surgical site infections.