According to literature data there is a fifty percent chance of infectious complication after colorectal surgery when antimicrobial agents are not used. Those drugs were first employed orally with fair results. A few years latter the parenteral route was introduced either alone or associated to administrations per os. This work presents a prospective study on infectious complications after coloretal cancer operations in 69 patients divided into two groups. The first group received oral neomycin and metronidazole in addition to parenteral gentamycin and metronidazole; the second group received only parenteral gentamycin and metronidazole. Every patient had a previous bowel cleansing by oral administration of a 1.500ml solution of 10% manitol. The main objective was to evaluate the influence of administering antimicrobials for intestinal preparation on the incidence of postsurgical infectious complications. The abdominal wall soiling, intra-abdominal sepsis and/or fistula were considered as infectious complication. In those cases a bacterial culture was performed. Patients receiving oral antimicrobials during bowel preparation presented lower percentage of infectious complications (14,2%) compared to those receiving only parenteral antimicrobials (38,24%); this difference being statistically significant at the level of 5%. Oral antimicrobials for bowel preparation were efficient in reducing the incidence of infectious complications after surgery for colorectal cancel: These data confirm the recommendation for the association of oral and parenteral antimicrobials for best prevention of infectious complications.
Colorectal surgery; Intestinal sterilization; Bacterial flora; Antimicrobial prophilaxis