INTRODUCTION: Surgical therapy of @entity189 or @entity418 by transthoracic esophageal resection is associated with a high morbidity in which @entity580 have a great importance. This study investigates the influence of prophylactic selective bowel decontamination on the course and results of transthoracic resection of the esophagus. METHODS: Seventy @entity1 with @entity189 and @entity418 were included in this prospective and partially randomized study at the University of Heidelberg. Twenty-five @entity1 received prophylactically selective bowel decontamination with @entity2890 , @entity6414 and @entity2379 . The treatment course was documented uniformly. In addition, microbiological screening was performed by swab examinations of nose, throat and anus, by urine and blood cultures, and the documentation of results of additional microbiological diagnostic studies. RESULTS: Bacteriological screening confirmed a reduction in infectious agents and a change of their spectrum in the respiratory and digestive tract without an increase in multiresistant bacteria. @entity1 who received selective bowel decontamination had a lower infection rate, a shorter artificial respiration period and a shorter intensive care stay without statistically significant differences. The mortality rate was 4% vs 9% in the control group (95% confidence interval -0.172-0.116). CONCLUSION: This study confirms the feasibility and microbiological effectiveness of selective bowel decontamination in the context of surgical therapy which is associated with a high @entity580 rate. The result of the clinical treatment seems slightly more favorable in the treatment group. Decisive are complications caused by surgery which fundamentally determine the clinical course and frequently cause infectious complications. The prophylactic use of selective bowel decontamination may be useful in @entity1 with an increased risk of prolonged ventilation support or colon interposition but it is not to be generally recommended.

[Microbiological and clinical effects of selective bowel decontamination in transthoracic resection of XXXX and @entity418 ].

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients'] @entity2890 :: ('MESH:D014031', 'Chemical') :: ['tobramycin'] @entity2379 :: ('MESH:D000666', 'Chemical') :: ['amphotericin B'] @entity6414 :: ('MESH:D011112', 'Chemical') :: ['polymyxin B'] @entity189 :: ('MESH:D002277', 'Disease') :: ['carcinoma of the esophagus'] @entity418 :: ('MESH:D004938', 'Disease') :: ['cardia'] @entity580 :: ('MESH:D003428', 'Disease') :: ['nosocomial infection', 'nosocomial infections']
@entity189 :: (MESH:D002277,Disease) :: ['carcinoma of the esophagus']
