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Perioperative Selective Decontamination of the Digestive Tract (SDD) in Elective Colorectal Surgery

  • Original Article
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Journal of Gastrointestinal Surgery Aims and scope

Abstract

Background

Selective decontamination of the digestive tract (SDD) decreases morbidity and mortality in critically ill patients and morbidity in patients undergoing esophageal resection. This study analyzes the effect of perioperative SDD in patients undergoing elective colorectal surgery on postoperative infections and anastomotic leakage.

Methods

This is a retrospective analysis of prospectively collected data in a 3-year cohort of 162 patients undergoing elective resection of colon and or rectum. Of these patients, 76 (47%) received SDD (polymyxine B sulfate, tobramycin, and amphotericin) perioperatively. The control group consisted of 86 patients who were not treated with SDD. Postoperative complications, hospital stay, and mortality were analyzed.

Results

In the SDD group, there were six patients (7.9%) with infectious complications compared with 17 patients (19.8%) in the control group (p = 0.031). The incidence of the combined endpoint infectious complications and anastomotic leakage was 8 (11%) in the SDD group vs. 22 (26%) in the control group (p = 0.014). Multivariate analysis showed that no-SDD, aged above 60 years and diabetes were independent predictors of postoperative complications.

Conclusion

Perioperative SDD in elective colorectal surgery seems to reduce postoperative surgical complications including infectious complications and anastomotic leakage. Prospective, randomized, placebo-controlled studies are needed to confirm this conclusion.

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Acknowledgments

The authors thank Dr. van Saene for his comments and helpful advice in the revision of the manuscript. We also thank Dr. M. Simons for supplying the database of prospectively collected data on postoperative complications of all patients admitted to our hospital.

Author information

Authors and Affiliations

  1. Departement of Surgery, Onze Lieve Vrouwe Gasthuis, Oosterpark 9, 1091 AC, Amsterdam, The Netherlands

    Daphne Roos, Brigitte M. Sondermeijer, Laurens T. de Wit & Michael F. Gerhards

  2. Teaching Hospital, Onze Lieve Vrouwe Gasthuis, Oosterpark 9, 1091 AC, Amsterdam, The Netherlands

    Lea M. Dijksman

  3. Intensive Care Unit, Onze lieve Vrouwe Gasthuis, Oosterpark 9, 1091 AC, Amsterdam, The Netherlands

    Heleen M. Oudemans-van Straaten

Authors
  1. Daphne Roos
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  2. Lea M. Dijksman
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  3. Brigitte M. Sondermeijer
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  4. Heleen M. Oudemans-van Straaten
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  5. Laurens T. de Wit
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  6. Michael F. Gerhards
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Corresponding author

Correspondence to Daphne Roos.

Additional information

Results were presented at a scientific meeting: Frontiers in Critical Care, NVIC, November 2008, Beurs van Berlage, Amsterdam, The Netherlands.

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Roos, D., Dijksman, L.M., Sondermeijer, B.M. et al. Perioperative Selective Decontamination of the Digestive Tract (SDD) in Elective Colorectal Surgery. J Gastrointest Surg 13, 1839–1844 (2009). https://doi.org/10.1007/s11605-009-0970-z

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  • DOI: https://doi.org/10.1007/s11605-009-0970-z

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