Our Summary

This research paper discusses a study that looked at whether giving patients an oral antibiotic bowel preparation (OABP) before an emergency colectomy (a surgery to remove part of the colon) has the same benefits as when it’s given before a planned colectomy. The study used data from the American College of Surgeons National Surgical Quality Improvement Program to compare health outcomes for adults who had this surgery between 2012 and 2019 and either received the OABP or did not.

Before matching the groups for comparison, those who received no preparation were more likely to have health conditions like diabetes and hypertension, as well as other preoperative conditions. After matching, the study found that patients receiving OABP had fewer surgical site infections in the organ space (11.2% vs. 15.5%) and less ileus (a disruption of the intestines’ normal propulsive ability) (30.3% vs. 35.3%). There was no difference in leak rates (3.3% for both groups) or major complications (47.4% vs. 49.9%).

The study suggests that giving OABP before an urgent colectomy can help reduce the risk of certain complications, so it should be considered when possible.

FAQs

  1. Does giving an oral antibiotic bowel preparation (OABP) before an emergency colectomy have the same benefits as when it’s given before a planned colectomy?
  2. What are the health benefits of receiving an OABP before undergoing a colectomy?
  3. How does receiving an OABP before a colectomy affect the risk of surgical site infections and intestinal disruptions?

Doctor’s Tip

One helpful tip a doctor might tell a patient about colectomy is to follow the preoperative instructions provided by the medical team. This may include taking any prescribed bowel preparations, fasting before the surgery, and avoiding certain medications. Following these instructions can help improve the success of the surgery and reduce the risk of complications.

Suitable For

Patients who are typically recommended for colectomy include those with:

  1. Colon cancer
  2. Inflammatory bowel disease (such as ulcerative colitis or Crohn’s disease)
  3. Diverticulitis
  4. Familial adenomatous polyposis (an inherited condition that causes multiple polyps in the colon)
  5. Chronic constipation or bowel obstruction
  6. Severe colorectal trauma or injury

In some cases, colectomy may be recommended as an emergency procedure for conditions such as perforation of the colon, severe bleeding, or a blocked intestine. In these situations, giving patients an oral antibiotic bowel preparation before surgery may help reduce the risk of complications and improve outcomes.

Timeline

Before colectomy:

  1. Patient is diagnosed with a condition that requires a colectomy, such as colorectal cancer or inflammatory bowel disease.
  2. Patient undergoes preoperative testing and consultations with surgeons and other healthcare providers.
  3. Patient may receive preoperative bowel preparation instructions, which may include dietary changes and the use of laxatives.
  4. Patient may experience symptoms related to their condition, such as abdominal pain, diarrhea, or bleeding.

After colectomy:

  1. Patient undergoes the surgical procedure to remove part of the colon.
  2. Patient is monitored closely in the postoperative period for complications such as infection, ileus, or leakage from the surgical site.
  3. Patient may experience pain, fatigue, and changes in bowel habits as they recover from surgery.
  4. Patient receives postoperative care, including pain management, wound care, and physical therapy.
  5. Patient may need to make dietary and lifestyle changes to support their recovery and adjust to life with a partial or total colectomy.
  6. Patient may undergo follow-up appointments with their healthcare team to monitor their recovery and address any concerns or complications.

What to Ask Your Doctor

Some questions a patient should ask their doctor about colectomy include:

  1. Should I receive an oral antibiotic bowel preparation before my colectomy surgery?
  2. What are the potential benefits of receiving an oral antibiotic bowel preparation before surgery?
  3. Are there any risks or side effects associated with receiving an oral antibiotic bowel preparation?
  4. How will the oral antibiotic bowel preparation be administered and what is the process like?
  5. Will receiving an oral antibiotic bowel preparation affect my recovery time or post-operative care?
  6. Are there any alternative bowel preparation methods that could be considered?
  7. How will receiving an oral antibiotic bowel preparation impact my risk of surgical site infections or other complications?
  8. What is the success rate of using an oral antibiotic bowel preparation in reducing the risk of complications during and after surgery?
  9. How will my medical history and current health conditions impact the decision to receive an oral antibiotic bowel preparation?
  10. Are there any specific instructions or precautions I should follow before or after receiving the oral antibiotic bowel preparation?

Reference

Authors: Salama E, Al-Rashid F, Pang A, Ghitulescu G, Vasilevsky CA, Boutros M. Journal: J Gastrointest Surg. 2022 Oct;26(10):2193-2200. doi: 10.1007/s11605-022-05440-8. Epub 2022 Aug 24. PMID: 36002788