A total of 169 patients undergoing colorectal surgery were randomly allocated to receive either gentamicin plus metronidazole or oral ciprofloxacin plus metronidazole as prophylaxis; they were also allocated to receive cover for 1 or 3 days. Twenty-eight patients (17 per cent) developed postoperative wound infections. The proportion of patients with wound infections and other infective complications was significantly less (P < 0.02) in those receiving oral ciprofloxacin. Cover for 3 days was no better than that for only 1 day. Oral ciprofloxacin for prophylaxis may offer advantages in efficacy and ease of administration compared with parenteral antibiotics.

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The concept underlying hepatic arterial chemotherapy is an attempt to raise the therapeutic index by increasing the concentration of drug within the organ harboring metastatic deposits, while reducing the amount of drug reaching the systemic vascular compartment. Intravascular targeting of cytotoxic drugs can occur at three levels': Level 1 : the drug carrier may be selectively distributed to the vascular compartment of the target organ harboring tumor; Level 2: the drug may be selectively directed to intraparenchymal tumor cells rather than intraparenchy- ma1 normal cells; Level 3: the drug may be taken up by tumor cells and selectively exert its cytotoxic effect. Attempts have been made to increase the selective advantage of intraarterial MMC by encapsulating it in albumin microspheres (drug payload 5% w/w),~ or by coadministering biodegradable starch microspheres to reduce hepatic blood flow and increase parenchymal drug uptake, with partial success.'Kato and co-workers have synthesized MMC-loaded microcapsules: nonbiodegradable ethylcellulose particles of approximately 250 pm diameter. containing 80% W/ W of drug.4 There is a large body of evidence, predominantly from Japan, suggesting that first-level targeting occurs after intraarterial administration of ethylcelluloseencapsulated MMC. Sugita and associates reported a nonrandomized study of 140 patients with hepatocellular carcinoma treated by intraarterial infusion of MMC and various other agents5 A 35% partial response rate was noticed in the patients (n = 32) treated with MMC microcapsules alone.There are few, if any, reports of clinical use of microencapsulated MMC in patients with colorectal liver metastases from centers outside Japan. In this study, the phar-952