Chinese expert consensus on wound pretreatment and antibiotic application in endoscopic super minimally invasive surgery(2023, Beijing)

doi:10.3877/cma.j.issn.2095-7157.2023.02.002

Abstract

Abstract:

Objective

In recent years, many hospitals both home and abroad have performed a series of surgeries under the concept of super minimally invasive surgery (SMIS), which highlights the advantages of SMIS.However, there is no expert consensus on wound pretreatment and antibiotic application for this type of surgery.This consensus aims to discuss the issues of wound pretreatment and antibiotic application in digestive endoscopic SMIS based on the best available scientific evidence.

Methods

Experts were recruited from the Super Minimally Invasive Surgery Group, ERCP Group, Ultrasound Endoscopy Group, Endoscopic Surgery Group, Early Gastrointestinal Cancer Collaborative Group, Esophageal Disease Collaborative Group, Gastric Disease Collaborative Group, Pancreatic Disease Collaborative Group and Endoscopic Tunneling Technology Group of Chinese Society of Digestive Endoscopology to form the expert group and a clinical question list was created.Each question was assigned to experts to form the statements which were then discussed and revised to reach agreement in 3 online and offline meetings between November 2022 and April 2023. Finally, the full statement collection was sent to all expert group members to grade the evidence, classify the statements, and vote on the strength of the statements.

Results

Sixteen statements on surgical wound pretreatment and antibiotic application in four surgical channels of digestive endoscopic SMIS were formulated, including 5 statements on surgical wound pretreatment and 11 statements on antibiotic application.

Conclusions

The consensus on wound pretreatment and antibiotic application for digestive endoscopic SMIS is the first published among all societies. This consensus recommends that in the clinical practice of SMIS, endoscopists should fully consider the characteristics of different surgical channels, choose different wound pretreatment and antibiotic application methods, formulate isolation measures, strictly disinfect the endoscope, and use disposable sterile instruments to minimize the incidence of infection. In addition, multi-cavity channels involve the field of minimally invasive surgery, so surgical procedures should be followed at the same time.

Key words: Super minimally invasive surgery, Wound pretreatment, Antibiotic application, Guideline

Chinese Society of Digestive Endoscopology, Beijing 100710, China. Chinese expert consensus on wound pretreatment and antibiotic application in endoscopic super minimally invasive surgery(2023, Beijing)[J]. Chinese Journal of Gastrointestinal Endoscopy(Electronic Edition), 2023, 10(02): 83-91.

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References 79

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推荐等级	说明
A+	非常同意
A	同意但有少许保留意见
A－	同意但有较多保留意见
D－	不同意但有较多保留意见
D	不同意但有少许保留意见
D+	完全不同意

推荐等级	说明
A+	非常同意
A	同意但有少许保留意见
A－	同意但有较多保留意见
D－	不同意但有较多保留意见
D	不同意但有少许保留意见
D+	完全不同意

证据等级	说明
高等质量	进一步研究也不可能改变该疗效评估结果的可信度
中等质量	进一步研究很可能影响该疗效评估结果的可信度，且可能改变该评估结果
低等质量	进一步研究极有可能影响该疗效评估结果的可信度，且该评估结果很可能改变
极低等质量	任何疗效评估结果都很不确定

证据等级	说明
高等质量	进一步研究也不可能改变该疗效评估结果的可信度
中等质量	进一步研究很可能影响该疗效评估结果的可信度，且可能改变该评估结果
低等质量	进一步研究极有可能影响该疗效评估结果的可信度，且该评估结果很可能改变
极低等质量	任何疗效评估结果都很不确定

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