Trends in Preparation for Colorectal Surgery: Survey of the Members of the American Society of Colon and Rectal Surgeons
Trends in Preparation for Colorectal Surgery: Survey of the Members of the American Society of Colon and Rectal Surgeons
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结直肠手术准备趋势：美国结直肠外科医生协会会员调查
DOI：
10.1177/000313480306900214
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发表时间：
2003
期刊：
影响因子：
--
通讯作者：
E. Weiss
中科院分区：
文献类型：
--
作者：
O. Zmora;S. Wexner;Luay Hajjar;Taeseok Park;J. Efron;J. Nogueras;E. Weiss
抗生素和机械准备在结直肠手术中的应用是有争议的，并且使用了许多不同的方案。本研究的目的是检测美国结肠和直肠外科医生的手术准备趋势。在美国执业的美国结肠和直肠外科医生协会的成员接受了关于结肠和直肠手术常规准备的邮寄问卷调查。在发送的1295份问卷中，有515份（40%）被退回。81%的受访者完成了经认可的结直肠培训计划，平均实践经验为13.7（±8.7）年。一半的外科医生认为预防性口服抗生素是必要的，41%的人认为这是值得怀疑的，10%的人认为口腔预防是不必要的。尽管有这些声明，75%的外科医生经常使用口服抗生素（其中96%使用两种药物的组合），11%选择性使用，只有13%的人在实践中省略了口腔预防。同样，尽管11%的外科医生质疑静脉注射抗生素的有效性，但98%的外科医生经常使用它们。术后平均给药次数为2次（±1.9）。尽管10%的外科医生质疑机械准备的重要性，但超过99%的外科医生经常使用它，47%的外科医生使用磷酸钠，32%的外科医生使用聚乙二醇，14%的外科医生在这两种选择之间交替使用。我们的结论是，虽然使用口服抗生素预防结直肠手术是有争议的外科医生，它仍然是常规实践的75%.Intravenous抗生素预防和机械清洗，然而，仍然是一个教条，几乎总是使用。有一种趋势是使用较短疗程的术后静脉注射抗生素和使用磷酸钠进行机械清洁。
The utility of antibiotic and mechanical preparation for colorectal surgery is controversial, and numerous different regimens are used. The aim of this study was to detect trends in preparation for surgery among American colon and rectal surgeons. Members of the American Society of Colon and Rectal Surgeons practicing in the United States were surveyed with a postal questionnaire regarding their routine preparations for colon and rectal surgery. Five hundred fifteen (40%) of the 1295 questionnaires sent were returned. Eighty-one per cent of the respondents had completed an accredited colorectal training program, and the average experience in practice was 13.7 (±8.7) years. Half of the surgeons felt that prophylactic oral antibiotic is essential, 41 per cent felt it was doubtful, and 10 per cent considered oral prophylaxis unnecessary. Despite these statements 75 per cent of the surgeons routinely utilized oral antibiotics (96% of them used a combination of two drugs), 11 per cent used them selectively, and only 13 per cent omitted oral prophylaxis from their practice. Similarly although the usefulness of intravenous antibiotics was questioned by 11 per cent of the surgeons 98 per cent routinely used them. The average number of postoperative doses was two (±1.9). Although 10 per cent of the surgeons questioned the importance of mechanical preparation more than 99 per cent routinely used it. Forty-seven per cent of the surgeons used sodium phosphate, 32 per cent used polyethylene glycol, and 14 per cent alternated between these two options. We conclude that although the use of oral antibiotic prophylaxis for colorectal surgery is controversial among surgeons it is still routinely practiced by 75 per cent. Intravenous antibiotic prophylaxis and mechanical cleansing, however, are still a dogma and almost invariably used. There is a trend toward the use of a shorter course of postoperative intravenous antibiotics and the use of sodium phosphate for mechanical cleansing.