Colorectal Cancer Clinical Trial
Official title:
Prospective Randomized Monocentric Trial of Mechanical Bowel Preparation Alone vs Mechanical Bowel Preparation Combined With Oral Antibiotics Before Colorectal Resections for Cancer
Investigation of the role of adding oral antibiotics to preoperative mechanical bowel preparation before colorectal surgery for cancer.
The aim of the study is to investigate whether the addition of oral antibiotics to Mechanical
Bowel Preparation (MBP) prior to colorectal cancer surgical procedures reduce the superfical
and deep surgical site (SSI) infectious complications. The study is prospective and is
designed in a randomized single-blinded controlled fashion. It is taking place at one
academic surgical unit of Athens Medical School, located at a tertiary referal institution.
Patients scheduled to undergo an elective surgical resection for colon or rectal cancer will
be allocated to either formal MBP the day before surgery or a combined MBP with
administration of oral antibiotics. Exclusion criteria are the following: emergency surgery,
obstructive or perforated cancer, patients intolerance to bowel preparation regimen and
allergies to orally administered antibiotics.
Intervention arms: Patients will be randomised into two groups, concealed from the treating
surgeon.
Group A:
Preoperative oral antibiotic therapy with rifaximin 400 mg plus metronidazole 500mg the day
prior to surgery at 2:00, 3:00 and 10:00 pm, with MBP (2 vials sodium phospate 45ml at 1:00
and 7:00 pm)
Group B:
MBP (2 vials sodium phospate 45ml at 1:00 and 7:00 pm) alone Both groups will receive iv
antibiotics (cefoxitin 2 gr plus metronidazole 500gr) perioperatively and discontinuation
within 24 hours.
Outcome measures: The primary end point is surgical site infection (SSI), including (i)
superficial wound infection, (ii) deep wound infection, and (iii) intrabdominal infection
(contaminated fluid or pus collection) within 30 days of the procedure (decrease 3% in the
rate) Secondary measures: Anastomotic leaks, other surgical and non-surgical compliactions,
hospital length of stay, readmission rate, patients' preparation tolerance, preparation
regimens side-effects, time to beginning of adjuvant treatment for colorectal cancer.
Sample Size: It is estimated that 105 patients per treatment arm are needed.
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