{
  "abstract": "Background Endoscopic submucosal dissection (ESD) is a primary minimally invasive intervention for colorectal neoplasms. However, postoperative complications such as fever, abdominal pain, and elevated C-reactive protein (CRP) remain clinical challenges. The necessity of prophylactic antibiotic administration to mitigate these risks is currently a subject of debate. This study aims to evaluate the clinical utility of prophylactic antibiotics post-ESD through both a systematic meta-analysis and a single-center retrospective clinical study.Methods Meta-analysis: A systematic search of PubMed, Embase, and The Cochrane Library was conducted. Data from eligible studies were analyzed using RevMan 5.4 to assess outcomes including infection rates, fever, and inflammatory parameters.Clinical Study: Data from 162 patients undergoing colorectal ESD between January 2023 and December 2025 at The First Affiliated Hospital of Xi’an Medical University were retrospectively reviewed. Patients were divided into an antibiotic group (n=100) and a control group (n=62). To eliminate baseline bias, a 1:1 nearest neighbor propensity score matching (PSM) (caliper = 0.05) was applied. Primary endpoints included postoperative infection, fever, and Visual Analogue Scale (VAS) scores for pain at 24 h and 72 h.Results Meta-analysis: Five studies were included. Pooled results demonstrated that prophylactic antibiotics significantly reduced the risk of postoperative infection (RR=0.39, 95% CI: 0.19–0.79, P=0.008) ( IDDF2026-ABS-0211 Figure 1. Forest plot of the meta-analysis on the effect of prophylactic antibiotics on postoperative infection), abnormal CRP elevation (RR=0.33, 95% CI: 0.17–0.66, P=0.002) (IDDF2026-ABS-0211 Figure 2. Forest plot of the meta-analysis on the effect of prophylactic antibiotics on abnormal CRP elevation), and Abdominal Pain (RR=0.36, 95% CI: 0.13–0.98, P=0.05) (IDDF2026-ABS-0211 Figure 3. Forest plot of the meta-analysis on the effect of prophylactic antibiotics on postoperative Abdominal Pain). No significant impact on postoperative bleeding was observed (P=0.97) (IDDF2026-ABS-0211 Figure 4. Forest plot of the meta-analysis on the effect of prophylactic antibiotics on postoperative bleeding). Clinical Study: After PSM, 58 pairs (n=116) were successfully matched. No statistically significant differences were observed between the ­antibiotic and control groups regarding postoperative infection (4 vs. 3 cases, P=0.697) or fever (6 vs. 4 cases, P=0.508). Furthermore, VAS scores for abdominal pain showed no significant difference at 24 h (0.47±1.047 vs. 0.33±0.735, P=0.413) or 72 h (0.19±0.395 vs. 0.07±0.256, P=0.054).Conclusions While the meta-analysis suggests that prophylactic antibiotics may reduce infection risks and inflammatory responses, our single-center retrospective study found no significant clinical benefit in reducing postoperative fever or pain. We recommend an individualized, short-course antibiotic strategy based on risk stratification to avoid unnecessary antibiotic exposure and support rational clinical use.Abstract IDDF2026-ABS-0211 Figure 1Abstract IDDF2026-ABS-0211 Figure 2Abstract IDDF2026-ABS-0211 Figure 3Abstract IDDF2026-ABS-0211 Figure 4",
  "authors": [
    {
      "affiliations": [
        "Department of Gastroenterology, The First Affiliated Hospital of Xi’an Medical University, China"
      ],
      "name": "Kunping Chen"
    },
    {
      "affiliations": [
        "Department of Gastroenterology, The First Affiliated Hospital of Xi’an Medical University, China"
      ],
      "name": "Mingxin Zhang"
    }
  ],
  "title": "IDDF2026-ABS-0211 Evaluation of prophylactic antibiotics after colorectal endoscopic submucosal dissection: a combined meta-analysis and propensity score-matched study",
  "uid": "6c804a3e-0464-500f-a206-9379dcee7a1c"
}