Letter to the Editor
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Jun 27, 2024; 16(6): 1953-1955
Published online Jun 27, 2024. doi: 10.4240/wjgs.v16.i6.1953
Evaluating bacterial contamination and surgical site infection risks in intracorporeal anastomosis: Role of bowel preparation
Junho Lee
Junho Lee, Department of Surgery, Hanyang University, College of Medicine, Seoul 04763, South Korea
Author contributions: Lee J designed and conducted the study and wrote the manuscript; the author has read and approved the final manuscript.
Conflict-of-interest statement: The author declares no conflicts of interest or financial ties for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Junho Lee, MD, PhD, Associate Professor, Department of Surgery, Hanyang University, College of Medicine, 222-1 Wangsimni-ro, Seongdong-gu, Seoul 04763, South Korea. duno82@gmail.com
Received: April 16, 2024
Revised: May 16, 2024
Accepted: June 4, 2024
Published online: June 27, 2024
Processing time: 74 Days and 15.3 Hours
Abstract

We recently read the study by Kayano et al on intracorporeal anastomosis (IA) for colon cancer, which assessed bacterial contamination and medium-term oncological outcomes and affirmed that IA is analogous to extracorporeal anastomosis in reducing intraperitoneal bacterial risk and achieving similar oncological results. Our commentary addresses gaps, particularly concerning bowel preparation and surgical site infections (SSIs), and highlights the need for comprehensive details on the bowel preparation methods that are currently employed, including mechanical bowel preparation, oral antibiotics (OA), their combination, and specific OA types. We emphasize the necessity for further analyses that investigate these methods and their correlation with SSI rates, to enhance clinical protocol guidance and optimize surgical outcomes. Such meticulous analyses are essential for refining strategies to effectively mitigate SSI risk in colorectal surgeries.

Keywords: Intracorporeal anastomosis, Surgical site infection, Mechanical bowel preparation, Oral antibiotics, Bacterial contamination, Colon cancer

Core Tip: We examined the study by Kayano et al on intracorporeal anastomosis for colon cancer, with a focus on its equivalence to extracorporeal anastomosis in managing bacterial risk and achieving oncological outcomes. A detailed examination of current bowel preparation methodologies that distinguishes between mechanical bowel preparation, oral antibiotics, or their combination and specific impact on surgical site infections (SSIs) is needed. Further research that precisely links bowel preparation methods with SSI rates are required to enhance patient outcomes and surgical safety during colorectal procedures. This critical insight urges a reevaluation of current practices and paves the way for substantial procedural improvements.