title: Effect of Peritoneal Lavage with Clindamycin-Gentamicin Solution during Elective Colorectal Cancer Surgery on the Oncologic Outcome.
abstract: BACKGROUND
  Antibiotics combined with lavage have demonstrated a reduction in the bacterial contamination and decreases surgical site infection (SSI) rate. SSI leads to an immunocompromised situation, as immunologic defense is focused on controlling the septic focus, leaving unattended the neoplasm. It has been described that SSI may result in a worse oncologic outcome. The aim of this study is to evaluate prospectively the effect of peritoneal lavage with clindamycin and gentamicin on the oncologic outcome of colorectal tumors.
  
  
  METHODS
  A randomized study of patients with diagnosis of colorectal neoplasms and undergoing elective surgery was performed at our institutions between January and September 2011. Patients were randomly assigned into two groups: Those undergoing an intra-abdominal lavage with normal saline (Group 1) and those undergoing an intra-abdominal lavage with a gentamicin-clindamycin solution (Group 2). Recurrence, global survival, and disease-free survival were investigated.
  
  
  RESULTS
  One hundred and four patients were analyzed, with 52 in each group. After a minimum follow-up of 42 mo, mean disease-free survival was 37.2 ± 14.2 mo in Group 1 and 25.8 ± 16.3 mo in Group 2 (mean difference 11.4; confidence interval (CI) 95% (2.2-25.1); p = 0.009). Mean global survival was 44.2 ± 11.9 mo in Group 1 and 34.1 ± 14.1 mo in Group 2 (mean difference 10.1; CI 95% (2.2-18);p = 0.016).
  
  
  CONCLUSIONS
  The intra-peritoneal lavage with gentamicin and clindamycin increases the disease-free and global survival colorectal tumors.
authors.affiliation: 1 Department of Surgery, Hospital Rey Juan Carlos , Madrid, Spain .
authors.forename: Jaime
authors.initials: J
authors.lastname: Ruiz-Tovar
authors.affiliation: 2 Department of Surgical Nursery, Hospital Sureste , Madrid, Spain .
authors.forename: Carolina
authors.initials: C
authors.lastname: Llavero
authors.affiliation: 3 Department of Pathology, Universidad Autonoma de Madrid , Madrid, Spain .
authors.forename: Carlos
authors.initials: C
authors.lastname: Gamallo
authors.affiliation: 4 Department of Surgery, Aintree Hospital , Liverpool, United Kingdom .
authors.forename: Jair
authors.initials: J
authors.lastname: Santos
authors.affiliation: 5 Department of Surgery, General University Hospital Elche , Alicante, Spain .
authors.forename: Rafael
authors.initials: R
authors.lastname: Calpena
authors.forename: Antonio
authors.initials: A
authors.lastname: Arroyo
authors.forename: Alberto
authors.initials: A
authors.lastname: Lopez
authors.forename: Fernando
authors.initials: F
authors.lastname: Candela
mesh_terms: D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D002981:Clindamycin / Q000008:administration & dosage*; D015179:Colorectal Neoplasms / Q000601:surgery*; D005260:Female; D005839:Gentamicins / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010533:Peritoneal Lavage / Q000379:methods*; D011446:Prospective Studies; D013514:Surgical Procedures, Operative / Q000009:adverse effects*; D013530:Surgical Wound Infection / Q000517:prevention & control*; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D005839:Gentamicins; D002981:Clindamycin