AimThe role of bowel preparation before colectomy in Crohn's disease patients remains controversial. This retrospective analysis of a prospective cohort study aimed to investigate the clinical outcomes associated with mechanical and antibiotic colon preparation in patients diagnosed with Crohn's disease undergoing elective colectomy.MethodData were collected from the American College of Surgeons National Surgical Quality Improvement Program participant user files from 2016 to 2021. A total of 6244 patients with Crohn's disease who underwent elective colectomy were included. The patients were categorized into two groups: those who received combined colon preparation (mechanical and antibiotic) and those who did not receive any form of bowel preparation. The primary outcomes assessed were the rate of anastomotic leak and the occurrence of deep organ infection. Secondary outcomes included all‐cause short‐term mortality, clinical‐related morbidity, ostomy creation, unplanned reoperation, operative time, hospital length of stay and ileus.ResultsCombined colon preparation was associated with significantly reduced risks of anastomotic leak (relative risk 0.73, 95% CI 0.56–0.95, P = 0.021) and deep organ infection (relative risk 0.68, 95% CI 0.56–0.83, P < 0.001). Additionally, patients who underwent colon preparation had lower rates of ostomy creation, shorter hospital stays and a decreased incidence of ileus. However, there was no significant difference in all‐cause short‐term mortality or the need for unplanned reoperation between the two groups.ConclusionThis study shows that mechanical and antibiotic colon preparation may have clinical benefits for patients with Crohn's disease undergoing elective colectomy.

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克罗恩病选择性结肠切除术的肠道准备：使用 NSQIP 数据库进行的全球队列研究的结果

目的克罗恩病患者结肠切除术前肠道准备的作用仍存在争议。这项前瞻性队列研究的回顾性分析旨在调查接受选择性结肠切除术的克罗恩病患者机械和抗生素结肠准备相关的临床结果。方法数据收集自 2016 年美国外科医生学会国家手术质量改进计划参与者用户文件到 2021 年，总共纳入了 6244 名接受选择性结肠切除术的克罗恩病患者。患者被分为两组：接受联合结肠准备（机械和抗生素）的患者和未接受任何形式肠道准备的患者。评估的主要结果是吻合口瘘发生率和深部器官感染的发生率。次要结局包括全因短期死亡率、临床相关发病率、造口术、计划外再次手术、手术时间、住院时间和肠梗阻。 结果联合结肠准备与吻合口瘘风险显着降低相关（相对风险 0.73, 95 % CI 0.56–0.95，磷= 0.021）和深部器官感染（相对风险 0.68，95% CI 0.56–0.83，磷< 0.001）。此外，接受结肠准备的患者造口率较低，住院时间较短，肠梗阻发生率较低。然而，两组之间的全因短期死亡率或计划外再次手术的需要没有显着差异。结论这项研究表明，机械和抗生素结肠准备可能对接受选择性结肠切除术的克罗恩病患者具有临床益处。