title: Local antibiotic therapy in rectal cancer surgery.
abstract: Infectious complications and their consequences are still key issues in rectal cancer surgery. Currently, intravenous antibiotic administration is a recognized method for lowering the rate of these complications. The aim of the study was to assess the efficacy of complementary application of a gentamicin-impregnated sponge in the perineal wound or in the vicinity of intestinal anastomosis after abdominoperineal resection or low anterior resection.
  
  
  METHODS
  112 patients with primary rectal cancer were enrolled in this study. 42 patients were treated with a gentamicin sponge and drainage (group A) and 70 individuals were treated with drainage alone (group B). In the aforementioned groups a routine short-term regimen of antibiotic prophylaxis was used. We applied gentamicin-impregnated sponges in 27 patients in whom anterior resection was performed and in 15 patients from the abdominoperineal resection group (64% and 36%, respectively). In the control group, 44 anterior resections and 26 abdominoperineal resections were carried out (63% and 37%, respectively).
  
  
  RESULTS
  We did not observe statistically significant differences in the incidence of suppurative complications (intraabdominal abscess, perineal wound infection): 4 cases (9.52%) in group A and 9 (12.58%) in group B and anastomotic leakage with clinical manifestation after low anterior resection: 1 case (3.7%) in group A and 2 (4.5%) in group B. Postoperative fever of unknown origin was noted more often in group B: 23 patients (32.8%) versus 10 patients (23.8%) in group A and this difference was statistically significant (p<0.05). Hospitalization after surgery was also significantly longer in group B (9-37 days, median 11 days) as compared with group A (8-26 days, median 13 days) (p<0.05).
  
  
  CONCLUSIONS
  Local antibiotic therapy in rectal cancer surgery lowered the incidence of postoperative fever of unknown origin and permitted shorter hospitalization after surgery. Local gentamicin application in rectal cancer surgery did not change significantly the rate of infectious complications.
authors: Zbigniew
authors: Z
authors: Morawiec
authors: Mariusz
authors: M
authors: Pawlak
authors: Agnieszka
authors: A
authors: Kołacińska
authors: Adam
authors: A
authors: Dziki
mesh_terms: D000287:Administration, Topical; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical / Q000379:methods; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D013505:Digestive System Surgical Procedures / Q000009:adverse effects / Q000379:methods*; D004322:Drainage; D005260:Female; D005335:Fever of Unknown Origin / Q000453:epidemiology / Q000209:etiology; D005839:Gentamicins / Q000008:administration & dosage*; D006801:Humans; D015994:Incidence; D007430:Intraoperative Care / Q000379:methods; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D012004:Rectal Neoplasms / Q000601:surgery*; D015503:Surgical Sponges; D013530:Surgical Wound Infection / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*
chemical_list: D000900:Anti-Bacterial Agents; D005839:Gentamicins