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[Evaluation of efficacy of mechanical bowel preparation in colorectal surgery]
1Departamentul de Chirurgie, Spitalul Elias, Bucureşti. dramiron@yahoo.com
Abstract:
Mechanical bowel preparation (MBP) is commonly used for preparing patients before elective colorectal surgery. MBP has long been considered indispensable for the prevention of complications, especially of the infectious ones. There is little scientific evidence demonstrating the efficiency of this practice in reducing the rate of infectious complications. The purpose of this study was to evaluate the usefulness of MBP in colorectal surgery. A prospective non randomized study analyzed 99 patients divided into two groups (60 with and 39 without MBP) which underwent colonic surgery finished with anastomosis. Anastomotic fistulas rate was 5% in the group with MBP and 2.5% in the one without MBP, parietal suppuration appeared in 15% of the patients with MBP and in 15% of those without MBP. There was a single intraperitoneal abscess in the group with MBP. Recent randomised clinical studies evaluating MBP in elective colorectal surgery were unable to show its benefits or real effects when compared with the operations without preparation. Colorectal surgery without MBP can be safely performed having the same or even better results than the one with MBP.
Insights
Mechanical bowel preparation (MBP) is not essential for colorectal surgery. Studies show that performing colorectal surgery without MBP yields similar or better outcomes, challenging its long-held necessity.
Area of Science:
- Colorectal Surgery
- Surgical Preparation
Background:
- Mechanical bowel preparation (MBP) is a standard practice before elective colorectal surgery.
- It is traditionally believed to prevent infectious complications.
Purpose of the Study:
- To evaluate the clinical utility and necessity of MBP in colorectal surgery.
- To assess the impact of MBP on infectious complication rates.
Main Methods:
- A prospective, non-randomized study involving 99 patients undergoing colonic surgery with anastomosis.
- Patients were divided into two groups: one with MBP (60 patients) and one without MBP (39 patients).
Main Results:
- Anastomotic fistula rate was 5% with MBP vs. 2.5% without MBP.
- Parietal suppuration occurred in 15% of patients in both groups.
- One intraperitoneal abscess was observed in the MBP group.
Conclusions:
- Recent randomized trials and this study suggest MBP offers no significant benefit in elective colorectal surgery.
- Colorectal surgery can be safely performed without MBP, potentially with improved outcomes.
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