ro13-9904 and Ileus

Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) is associated with considerable postoperative morbidity, including ileus and infectious complications. Perioperative care is believed to be an important factor for the development and treatment of postoperative morbidity.. Data on case-matched patients from a retrospective database of 2 Dutch HIPEC centres was compared. Patient selection and procedures were identical in both hospitals although perioperative management items differ slightly. In centre B, immediate total parenteral nutrition (TPN), suprapubic urine bladder catheter placement (SPCs) and selective decontamination of the digestive-tract are standard care for CRS-HIPEC patients, while in centre A, they are not.. From a total of 223 patients, 68 consecutive patients from centre B were compared to 68 matched patients from centre A. TPN was administered to 54.4% of patients in centre A because of prolonged ileus, whereas it was standard of care in centre B. In all, 105 (77.2%) patients experienced postoperative complications including 17.6% who had a grades III-IV complication. The incidence of grade III-V complications was 18 (26.4%) in centre A and 8 (11.8%) in centre B (p = 0.03). Median hospital stay was 12 days (7-84) in A and 11(6-80) in centre B (p = 0.546).. Gastrointestinal recovery after CRS-HIPEC seems to take longer as compared to other surgical procedures. Between the 2 centres, a significant difference in severe complications was found, while standard TPN, selective bowel decontamination and SPCs were the only identified differences in perioperative care.

Topics: Aged; Anti-Bacterial Agents; Antibiotic Prophylaxis; Cefazolin; Ceftriaxone; Cytoreduction Surgical Procedures; Decontamination; Female; Humans; Hyperthermia, Induced; Ileus; Infusions, Parenteral; Intestines; Length of Stay; Male; Metronidazole; Middle Aged; Netherlands; Parenteral Nutrition; Perioperative Care; Recovery of Function; Retrospective Studies; Surgical Wound Infection; Urinary Catheterization

In experiment on the model of mechanical acute ileus (AI) in accordance to morphological and microbiological investigations data there was established, that in intestinal wall, situated above the obstacle place, purulent enteritis occurs, what may constitute the origin of purulent-septic complications after elimination of the Al cause. Application of antibacterial preparations permits to slow down the progression of destructive processes in the affected intestinal wall.

Topics: Ampicillin; Animals; Anti-Bacterial Agents; Bacteria; Ceftriaxone; Ciprofloxacin; Fluoroquinolones; Gentamicins; Ileitis; Ileum; Ileus; Injections, Intramuscular; Microbial Sensitivity Tests; Rats; Rats, Wistar

Antibiotics may impair small bowel smooth muscle contractility and contribute to postoperative ileus. The aim of this study was to compare the contractile responses of ileum smooth muscle to different agonists in guinea pigs treated with ceftriaxone (Rocephin; F. Hoffman-La Roche, Kaiseraugst, Switzerland) or ampicillin (Ampisina; Mustafa Nevzat Ilaç Sanayii AS, Istanbul, Turkey).. Twenty-four adult guinea pigs were randomly divided into three groups. Whereas eight of these received ceftriaxone sodium (100 mg/kg per day, i.m.) for 10 days, another eight guinea pigs received ampicillin (50 mg/kg per day, i.m.) for 10 days and the remaining eight served as the control group receiving 1 mL distilled water during 10 days as placebo. By the end of 10 days, the animals were killed and their ilea were excised. Ileum segments were placed in an organ bath; concentration-response relationship for carbachol and histamine were obtained by adding the reagent cumulatively to the bath.. pD(2) values being the same, maximum contractile responses (E(max)) to carbachol and histamine were significantly reduced in the ceftriaxone sodium group compared with the control group. No significant differences in E(max) and pD(2) values to carbachol and histamine were observed between the ampicillin group and the control group.. These data indicate that whereas ceftriaxone may impair small bowel smooth muscle contractility, ampicillin does not. There are implications for the long-term use of parenteral antibiotics in the postoperative period.

Topics: Ampicillin; Animals; Anti-Bacterial Agents; Ceftriaxone; Disease Models, Animal; Follow-Up Studies; Guinea Pigs; Ileum; Ileus; Injections, Intramuscular; Male; Muscle Contraction; Muscle, Smooth; Postoperative Complications; Time Factors