Background: The approach to perioperative antibiotic prophylaxis, bowel preparation, and
postoperative routines in elective colorectal resections has changed over the last two decades.
The aim of this national survey was to document the current methods of perioperative management
of those patients scheduled for elective colorectal resections in surgical departments
in Israel.
Methods: A mail and telephone survey of surgical departments was conducted in 2001 in
order to evaluate the routines of perioperative management of elective colorectal resections.
Re-evaluation was performed in 2004.
Results: In 2001, all but one of the responders used low-residue diet preoperatively and
combined oral and parenteral antibiotic prophylaxis. Polyethylene glycol or sodium phosphate
bowel preparation was used by 69% of the responders. The most common oral regimens
were a combination of neomycin plus metronidazole (43.5%) or neomycin plus erythromycin
(47.8%). The most common parenteral regimens used were gentamicin plus
metronidazole or gentamicin plus metronidazole plus ampicillin (56.5% and 17% of the responders,
respectively). Cephalosporins alone or in combination were used in three departments.
In 17 departments (74%), parenteral prophylactic antibiotics were continued for 24 h
or longer (up to 72 h). All but one of the departments left a nasogastric tube for 1–5 days after
surgery. There were substantial changes over the last three years—that is, less use of preoperative
restriction diets, shorter duration of perioperative antibiotic coverage, more common
use of cephalosporins, switch to sodium dihydrogen and sodium hydrogen phosphate
bowel preparation, shorter use of postoperative nasogastric drainage, and faster resumption
of peroral fluids.
Conclusions: In 2001, the majority of surgical departments in Israel used a conservative approach
to perioperative management of patients undergoing elective colorectal resections. Significant
changes occurred during the last three years. The perioperative routines used today
in most general surgery departments in Israel comply with current recommendations.
