中国结直肠手术术前肠准备的实践模式调查

Hongfeng Yu, Li Xu, Shuhao Liu, Songcheng Yin, Chunhong Hong, Shaohua Yang, Jingyao Chen, Jianfeng Li, Changhua Zhang
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摘要

长期以来,肠道准备一直被认为是结直肠手术的标准术前管理。然而,关于肠道准备仍存在争议,肠道准备的重要性逐渐下降。本研究的目的是描述目前中国外科医生对术前肠道准备的态度和实践模式。方法随机对中国外科医生进行11个问题的在线匿名调查。调查问卷旨在了解每位外科医生目前的术前肠道准备情况。结果来自26个省级行政区的384名外科医生参与了本次调查。选择肠道准备的最常见原因是防止手术部位感染(SSI)。同时,74%的中国外科医生认为肠道准备可以避免吻合口漏。只有34%的人认为肠道准备可以降低术后出血的风险。在肠道准备方法方面,57%的中国外科医生倾向于单独使用泻药。在药物的选择上,中国外科医生更倾向于选择聚乙二醇电解质灌洗液(PEG-ELS)。结论外科医生多选择肠道准备以避免SSI和吻合口漏,且倾向于单独使用泻药。我们的研究表明,外科医生没有明确的指导方针来指导他们的临床实践,关于肠道准备仍然存在争议。需要进一步的研究来为临床和政策决策提供有力的证据。
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A Chinese Survey of Current Practice Patterns of Preoperative Bowel Preparation in Colorectal Surgery
Background Bowel preparation has long been considered as the standard preoperative management for colorectal surgery. However, there are still controversies about bowel preparation and the importance of bowel preparation gradually declined. The purpose of this study is to describe the current attitudes and practice patterns of preoperative bowel preparation among Chinese surgeons. Methods An online 11-question anonymous survey was randomly assigned to Chinese surgeons. The questionnaire sought information on each surgeon’s current practice of preoperative bowel preparation. Results 384 Chinese surgeons from 26 provincial administrative regions took part in this survey. The most common reason for choosing bowel preparation was preventing surgical site infection (SSI). Meanwhile, 74% Chinese surgeons believed bowel preparation could avoid anastomotic leakage. Only 34% thought that bowel preparation was considered to reduce risk of postoperative bleeding. In terms of bowel preparation methods, 57% Chinese surgeons preferred to choose laxatives alone. Regarding the choices of agents, Chinese surgeons were more likely to choose polyethylene glycol-electrolyte lavage solution (PEG-ELS). Conclusions Surgeons choose bowel preparation mostly to avoid SSI and anastomotic leakage, and they prefer using laxatives alone. Our study shows that surgeons do not have clear guidelines that can govern their clinical practice and there are still controversies about bowel preparation. Further study is required to provide strong evidences to inform clinical and policy decisions.
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