J.Jpn. Surg. Soc.. 123(3): 221-227, 2022

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Feature topic

ACCUMULATING EVIDENCE FOR PERIOPERATIVE MANAGEMENT IN COLORECTAL CANCER SURGERY

In the perioperative management of patients who undergo colorectal cancer surgery, surgical site infections (SSIs) and anastomotic leakage are the most important issues. Although a consensus has been reached on the use of prophylactic antimicrobial agents for the prevention of SSIs, the efficacy of combined use of oral antimicrobial agents in the prevention of SSIs has also been demonstrated in bowel preparation, which is characteristic of colorectal surgery. On the other hand, there are many negative opinions about pelvic drain placement for the prevention of SSIs and anastomotic leakage in rectal cancer surgery, but the use of transanal drains based on their efficacy is increasing according to research from Asia, especially in Japan. Colorectal stenting, a preoperative management method for obstructive colorectal cancer, contributes to an increase in the primary anastomosis rate and a decrease in postoperative complications in subsequent surgeries, but there have been concerns about the worsening of oncological prognosis due to colonic perforation. In addition, negative-pressure wound therapy is attracting attention as a new method of SSI prevention. In this article, we describe the transition of perioperative management in colorectal cancer surgery patients, focusing on management for the prevention of SSIs and anastomotic leakage.

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