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Bowel preparation: current status

James E Duncan1, Christie M Quietmeyer

  • 1Department of Surgery, National Naval Medical Center (NNMC), Bethesda, MD 20889, USA. james.duncan@med.navy.mil

Clinics in Colon and Rectal Surgery
|February 2, 2010
PubMed

Insights

Mechanical bowel preparation (MBP) is a long-standing surgical practice. Emerging evidence suggests MBP offers no benefit in colorectal surgery and questions its routine use.

Area of Science:

  • Colorectal Surgery
  • Surgical Gastroenterology
  • Evidence-Based Medicine

Background:

  • Mechanical bowel preparation (MBP) has been a standard surgical practice for over a century.
  • The rationale includes improved visualization and reduced surgical site infections.
  • Surgeons widely accept MBP despite evolving methods and agents.

Purpose of the Study:

  • To review the history and agents of MBP in colorectal surgery.
  • To summarize recent evidence questioning the efficacy of MBP.
  • To evaluate the current role of MBP in surgical practice.

Main Methods:

  • Literature review of historical data on MBP.
  • Analysis of randomized controlled trials and meta-analyses.
  • Examination of emerging medical literature on preoperative bowel cleansing.

Main Results:

  • Recent trials and meta-analyses indicate MBP provides no significant benefit.
  • Evidence suggests MBP does not reduce infectious or anastomotic complications.
  • The necessity of MBP as a preoperative measure is increasingly questioned.

Conclusions:

  • The routine use of MBP in colorectal surgery is challenged by current evidence.
  • Further investigation is needed to determine the optimal role of bowel preparation.
  • Surgeons should reconsider the established protocols for MBP.
Keywords:
Mechanical bowel preparationcolorectal surgerypolyethylene glycolsodium phosphate

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