Manfaat Persiapan Usus Kombinasi Sebelum Operasi Kolorektal

Oleh :

dr. Sonny Seputra, Sp.B, M.Ked.Klin, FINACS

Persiapan usus sebelum operasi kolorektal bertujuan untuk menurunkan tingkat komplikasi operasi, termasuk infeksi, kebocoran anastomosis, dan dehisensi luka. Persiapan ini bisa dilakukan dengan teknik kombinasi, yakni gabungan persiapan usus mekanik (mechanical bowel preparation) dan persiapan usus antibiotik (antibiotic bowel preparation), yang telah dilaporkan memberi luaran klinis lebih baik dibandingkan persiapan usus tunggal.[1,2]

Persiapan Usus Mekanik (Mechanical Bowel Preparation)

Persiapan usus mekanik adalah prosedur pembersihan usus besar yang dilakukan sebelum operasi kolorektal untuk mengurangi beban feses dan meminimalkan risiko kontaminasi intraoperatif. Meski begitu, banyak bukti ilmiah telah menunjukkan bahwa pengerjaan prosedur ini secara tunggal (tanpa disertai persiapan dengan antibiotik) tidak menghasilkan manfaat klinis signifikan.

(Konten ini khusus untuk dokter. Registrasi untuk baca selengkapnya)

Referensi

1. Klinger AL, Green H, Monlezun DJ, et al. The Role of Bowel Preparation in Colorectal Surgery: Results of the 2012-2015 ACS-NSQIP Data. Ann Surg. 2019. 269(4):671-677. doi: 10.1097/SLA.0000000000002568.
2. Willis MA, Toews I, Soltau SLV, et al. Preoperative combined mechanical and oral antibiotic bowel preparation for preventing complications in elective colorectal surgery. Cochrane Database of Systematic Reviews 2023, Issue 2. Art. No.: CD014909. DOI: 10.1002/14651858.CD014909.pub2
3. Zhou X, He Y. Understanding perioperative bowel preparation for colorectal surgery. Dig Med Res 2020;3:3
4. Slim K, Martin G. Mechanical bowel preparation before colorectal surgery. Where do we stand? J Visc Surg. 2016 Apr;153(2):85-7. doi: 10.1016/j.jviscsurg.2015.10.004.
5. Liu S, Huang N, Wei C, et al. Is mechanical bowel preparation mandatory for elective colon surgery? A systematic review and meta-analysis. Langenbecks Arch Surg, 2024. 409: 99. https://doi.org/10.1007/s00423-024-03286-z
6. Woodfield JC, Clifford K, Schmidt B, et al. Strategies for Antibiotic Administration for Bowel Preparation Among Patients Undergoing Elective Colorectal Surgery: A Network Meta-analysis. JAMA Surg. 2022 Jan 1;157(1):34-41. doi: 10.1001/jamasurg.2021.5251.
7. Vadhwana B, Pouzi A, Surjus Kaneta G, et al. Preoperative oral antibiotic bowel preparation in elective resectional colorectal surgery reduces rates of surgical site infections: a single-centre experience with a cost-effectiveness analysis. Ann R Coll Surg Engl. 2020 Feb;102(2):133-140. doi: 10.1308/rcsann.2019.0117.
8. Kumar N, Giri Goswami A, Mallik D, et al. Bowel Preparation before Elective Colorectal Surgery: Its Current Role. Tertiary Care - Medical, Psychosocial, and Environmental Aspects. IntechOpen, 2024. http://dx.doi.org/10.5772/intechopen.107093
9. Scarborough JE, Mantyh CR, Sun Z, et al. Combined mechanical and oral antibiotic bowel preparation reduces incisional surgical site infection and anastomotic leak rates after elective colorectal resection: an analysis of colectomy-targeted ACS NSQIP. Ann Surg. 2015; 262:331–337

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