Perioperative antibiotic prophylaxis and antibiotic therapy for subtotal esophagectomy with one-stage esophagoplasty: analysis of the treatment of 500 patients

• Kovalerova N.B.
• Ruchkin D.V.
• Strunin O.V.
• Hamidov M.M.
• Kozlov V.A.

Abstract

Esophagectomy (EE) with one-stage esophagoplasty is a high–risk operation. Using enhanced recovery after surgery (ERAS) in perioperative support has improved patient treatment outcomes. However, the issue of antibiotic prophylaxis in these patients has not yet been definitively resolved. The recommendations for EE do not specifically address this issue. Analysis of the treatment of 500 patients at the National Medical Research Center for Surgery named after A.V. Vishnevsky showed that the use of ampicillin/sulbactam or amoxicilline/clavulanate combination intraoperatively and within 24–48 hours after the intervention, with possible subsequent antibiotic therapy, contributes to a low incidence of postoperative complications (29.2%). Anastomic leakage/apical necrosis of the conduit was detected in 4.4% of patients, subtotal necrosis in 2.2%, and postoperative pneumonia in 10% of patients. At the same time, isolated surgica l site infection was diagnosed in 1% of patients.

Keywords: esophagectomy; esophagoplasty; enhanced recovery after surgery; antibiotic prophylaxis

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