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Table 1: AMCG survey highlights compared |
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|
Mexican survey (%) |
Evidence-based literature |
Comments |
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Mechanical preparation |
89.5 perform mechanical preparation |
Controversial results No statistical significance has been observed between the use or non-use of mechanical bowel preparation |
A combination of oral antibiotics and mechanical bowel preparation should be considered. Further clinical trials are required |
|
Oral antibiotic prophylaxis |
69.2 indicate prophylaxis with oral antibiotics |
100% Its use decreased surgical site infection, dehiscence rate, ileus and major complications |
Combined use of mechanical preparation plus oral antibiotics decreased mortality |
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Smoking |
79 four-week suspension |
Ideally an eight week suspension |
Add Vit. C |
|
Nutritional status |
73.5 perform nutritional assessment |
Ideally 100% |
Malnutrition is a risk factor for major complications |
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Anastomosis |
28.7 use suture |
Variable |
Meta-analysis in favour of mechanical anastomosis in the right colon |
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Manual (suture) Mechanical (stapling) |
71.2 use a stapler |
Variable |
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|
Hermeticidad |
59.6 perform watertightness tests |
Ideally 100% |
Direct colonoscopical vision is best, but only 5.8% use it |
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Drainages |
72.4 indicate drainage |
No benefit in mortality, reoperations, anastomotic leakage, surgical site infection or respiratory complications |
Increase post-operative bowel obstruction |
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Nasogastric tube |
76.8 do not 20.8 use tube |
Not indispensable |
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