Systematic review of perioperative selective decontamination of the digestive tract in elective gastrointestinal surgery.

摘要: Background: Studies on selective decontamination of the digestive tract (SDD) in elective gastrointestinal surgery have shown decreased rates postoperative infection and anastomotic leakage. However, prophylactic use perioperative SDD is not generally accepted. Methods: A systematic review randomized clinical trials (RCTs) was conducted to compare effect with systemic antibiotics (SDD group) antibiotic prophylaxis alone (control group), using MEDLINE, Embase Cochrane Central Register Controlled Trials. Endpoints included infection, leakage, in-hospital or 30-day mortality. Results: Eight RCTs published between 1988 2011, a total 1668 patients (828 group 840 control were meta-analysis. The number (reported 5 trials) 77 (19·2 per cent) 401 group, compared 118 (28·2 418 (odds ratio 0·58, 95 cent confidence interval 0·42 0·82; P =0·002). incidence leakage significantly lower group: 19 (3· 3p er 582 versus 44 (7·4 595 0·42, 0·24 0·73; Conclusion: This meta-analysis suggests that combination intravenous reduces rate including alone.