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Selective Decontamination of the Digestive Tract in Gastrointestinal Surgery: Useful in Infection Prevention? A Systematic Review

  • Review Article
  • Published:
Journal of Gastrointestinal Surgery Aims and scope

Abstract

Introduction

Gastrointestinal surgery is associated with a high incidence of infectious complications. Selective decontamination of the digestive tract is an antimicrobial prophylaxis regimen that aims to eradicate gastrointestinal carriage of potentially pathogenic microorganisms and represents an adjunct to regular prophylaxis in surgery.

Material and Methods

Relevant studies were identified using bibliographic searches of MEDLINE, EMBASE, and the Cochrane database (period from 1970 to November 1, 2012). Only studies investigating selective decontamination of the digestive tract in gastrointestinal surgery were included.

Results

Two randomized clinical trials and one retrospective case–control trial showed significant benefit in terms of infectious complications and anastomotic leakage in colorectal surgery. Two randomized controlled trials in esophageal surgery and two randomized clinical trials in gastric surgery reported lower levels of infectious complications.

Conclusion

Selective decontamination of the digestive tract reduces infections following esophageal, gastric, and colorectal surgeries and also appears to have beneficial effects on anastomotic leakage in colorectal surgery. We believe these results provide the basis for a large multicenter prospective study to investigate the role of selective decontamination of the digestive tract in colorectal surgery.

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Authors and Affiliations

  1. Department of Surgery, VU University Medical Center, Amsterdam, The Netherlands

    Gabor S. A. Abis, Marjolein van Egmond, Hendrik J. Bonjer & Christina M. J. E. Vandenbroucke-Grauls

  2. Department of Surgery, Kennemer Gasthuis Teaching Hospital, Haarlem, The Netherlands

    Hein B. A. C. Stockmann

  3. Department of Surgery, Erasmus Medical Center, Rotterdam, The Netherlands

    Steven J. Oosterling

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  1. Gabor S. A. Abis
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  2. Hein B. A. C. Stockmann
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Correspondence to Gabor S. A. Abis.

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Abis, G.S.A., Stockmann, H.B.A.C., van Egmond, M. et al. Selective Decontamination of the Digestive Tract in Gastrointestinal Surgery: Useful in Infection Prevention? A Systematic Review. J Gastrointest Surg 17, 2172–2178 (2013). https://doi.org/10.1007/s11605-013-2379-y

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