oncotomskСибирский онкологический журналSiberian journal of oncology1814-48612312-3168Tomsk National Research Medical Сепtеr of the Russian Academy of Sciences10.21294/1814-4861-2019-18-3-97-102oncotomsk-1102Research ArticleОБЗОРЫREVIEWSСОВРЕМЕННЫЙ ВЗГЛЯД НА ОПТИМАЛЬНЫЕ СПОСОБЫ ПОДГОТОВКИ ТОЛСТОЙ КИШКИ ПЕРЕД ПЛАНОВЫМИ КОЛОРЕКТАЛЬНЫМИ ОПЕРАЦИЯМИMODERN VIEW ON DIFFERENT KINDS OF BOWEL PREPARATION FOR ELECTIVE COLORECTAL SURGERYhttps://orcid.org/0000-0002-1811-6226ОлькинаА. Ю.OlkinaA. Yu.

Олькина Александра Юрьевна, клинический ординатор

г. Санкт-Петербург, пос. Песочный, 197758, ул. Ленинградская, 68

Aleksandra Yu. Olkina, MD, Abdominal Surgery Department

68, Leningradskaya Street, Pesochnyi village, 197758-St. Petersburg

alexpetrov@doctor.comhttps://orcid.org/0000-0001-9630-9464ПетровА. С.PetrovA. S.

Петров Алексей Сергеевич, кандидат медицинских наук, врач-онколог хирургического отделения абдоминальной онкологии

г. Санкт-Петербург, пос. Песочный, 197758, ул. Ленинградская, 68

Aleksei S. Petrov, MD, PhD, Abdominal Surgery Department

68, Leningradskaya Street, Pesochnyi village, 197758-St. Petersburg

https://orcid.org/0000-0003-1233-7973ПанайоттиЛ. Л.PanaiottiL. L.

Панайотти Лидия Леонидовна, аспирант, врач-онколог хирургического отделения абдоминальной онкологии

г. Санкт-Петербург, пос. Песочный, 197758, ул. Ленинградская, 68

Lidiia L. Panaiotti, MD, Abdominal Surgery Department

68, Leningradskaya Street, Pesochnyi village, 197758-St. Petersburg

https://orcid.org/0000-0001-6641-7229КарачунА. М.KarachunA. М.

Карачун Алексей Михайлович, доктор медицинских наук, заведующий хирургическим отделением абдоминальной онкологии, ФГБУ «НМИЦ онкологии им. Н.Н. Петрова» Минздрава РФ; профессор кафедры онкологии, Северо-Западный государственный медицинский университет им. И.И. Мечникова

г. Санкт-Петербург, пос. Песочный, 197758, ул. Ленинградская, 68, 

г. Санкт-Петербург, 191015, ул. Кирочная, 41

SPIN-код: 6088-9313

Aleksei M. Karachun, MD, PhD, Abdominal Surgery Department, N.N. Petrov National Medical Research Center of Oncology of the Ministry of Healthcare of Russian Federation

68, Leningradskaya Street, Pesochnyi village, 197758-St. Petersburg, 

41, Kirochnaya Street, 191015-St. Petersburg

https://orcid.org/0000-0001-9234-9936ЛанковТ. С.LankovT. S.

Карачун Алексей Михайлович, доктор медицинских наук, заведующий хирургическим отделением абдоминальной онкологии, ФГБУ «НМИЦ онкологии им. Н.Н. Петрова» Минздрава РФ; профессор кафедры онкологии, Северо-Западный государственный медицинский университет им. И.И. Мечникова

г. Санкт-Петербург, пос. Песочный, 197758, ул. Ленинградская, 68, 

 

 

Timur S. Lankov, MD, Abdominal Surgery Department

68, Leningradskaya Street, Pesochnyi village, 197758-St. Petersburg

ФГБУ «НМИЦ онкологии им. Н.Н. Петрова» Минздрава РФРоссияN.N. Petrov National Medical Research Center of OncologyRussian FederationФГБУ «НМИЦ онкологии им. Н.Н. Петрова» Минздрава РФ; Северо-Западный государственный медицинский университет им. И.И. МечниковаРоссияN.N. Petrov National Medical Research Center of Oncology; North-Western State Medical University named after I.I. MechnikovRussian Federation20193006201918397102Copyright © Олькина А.Ю., Петров А.С., Панайотти Л.Л., Карачун А.М., Ланков Т.С., 20192019Олькина А.Ю., Петров А.С., Панайотти Л.Л., Карачун А.М., Ланков Т.С.Olkina A.Y., Petrov A.S., Panaiotti L.L., Karachun A.М., Lankov T.S.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.siboncoj.ru/jour/article/view/1102

Цель исследования – обобщение имеющихся данных по влиянию применения разных подходов предоперационной подготовки кишки на непосредственные результаты при плановых операциях на толстой кишке.

Материал и методы

Материал и методы. С помощью электронной системы американской национальной медицинской библиотеки PubMed проводился поиск статей по ключевым словам: mechanical bowel preparation, surgical site infection, oral antibiotics. В ходе анализа изучено 226 статей, 31 из которых отобрана для окончательного обзора. Также для поиска текущих исследований использовалась электронная база ClinicalTrials.gov.

Результаты

Результаты. Применение механической подготовки кишки при операциях на толстой кишке считалось стандартом в течение многих лет. В настоящее время целесообразность механической подготовки кишки подвергается сомнению, в связи с чем рассматривается возможность полного отказа от механической подготовки кишки либо, напротив, дополнение механической подготовки кишки пероральными антибиотиками. В обзоре представлены данные литературы по влиянию применения разных подходов предоперационной подготовки кишки на непосредственные результаты.

Заключение

Заключение. Оптимальный способ предоперационной подготовки кишки остается предметом дискуссии в хирургическом сообществе. В настоящее время наиболее предпочтительным способом следует считать комбинацию MBP и пероральных антибиотиков. Однако данная область изучена недостаточно и требует проведения дополнительных рандомизированных исследований.

Purpose

Purpose: to assess current data on the effect of different approaches to preoperative bowel preparation before elective colorectal surgery on short-term treatment outcomes.

Material and Methods

Material and Methods. Online system PubMed of U.S. National Library of Medicine was used to find articles with key words “mechanical bowel preparation”, “surgical site infection”, “oral antibiotics”. A total of 226 articles were reviewed. 31 articles were selected for final review. Furthermore, ClinicalTrials.gov site was used to find actual and recruiting trials.

Results

Results. Mechanical bowel preparation (MBP) used to be a standard procedure for a long time. Nowadays, routine use of MBP seems to be debatable. Alternative approaches, e.g. absolutely no preparation or the use of MBP in combination with oral antibiotics, are considered. Data on performing different kinds of bowel preparation is reviewed in this article.

Conclusion

Conclusion. Optimal approach of preoperative bowel preparation is still questionable. Combination of mechanical bowel preparation and oral antibiotics seems to be a preferable method. However, there is not enough evidence to exclude anothertechniques. It’s required to conduct additional randomized controlled trials.

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The authors declare that there are no conflicts of interest present.