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Mechanical Bowel Preparation Does Not Affect Clinical Severity of Anastomotic Leakage in Rectal Cancer Surgery

Woong Bae Ji1, Koo Yong Hahn2, Jung Myun Kwak3

  • 1Division of Colorectal Surgery, Department of Surgery, Korea University Ansan Hospital, Korea University College of Medicine, Ansan-si, Republic of Korea.

World Journal of Surgery
|December 24, 2016
PubMed
Abstract

Insights

Omitting mechanical bowel preparation (MBP) in rectal cancer surgery did not increase anastomotic leakage rates. However, patients not undergoing MBP experienced less severe leakage requiring surgical intervention, with no difference in overall clinical severity.

Area of Science:

  • Colorectal surgery
  • Surgical oncology
  • Gastroenterology

Background:

  • Previous trials suggest omitting mechanical bowel preparation (MBP) is safe for rectal cancer surgery.
  • A key concern is the potential for increased fecal peritonitis with anastomotic leakage.
  • This study investigates clinical outcomes of anastomotic leakage with and without MBP.

Purpose of the Study:

  • To compare the clinical manifestations and severity of anastomotic leakage.
  • To evaluate the impact of mechanical bowel preparation (MBP) on anastomotic leakage outcomes in rectal cancer patients.

Main Methods:

  • Single-center retrospective review of a prospectively maintained database.
  • Analysis of 1369 patients undergoing elective rectal cancer resection with primary anastomosis (2006-2013).
  • Comparison of outcomes between patients with and without MBP.

Main Results:

  • Anastomotic leakage rates were similar: 9.27% without MBP vs. 7.81% with MBP.
  • Significantly lower rate of leakage requiring surgical exploration in the no-MBP group (39.0% vs. 71.4%).
  • No significant differences in hospital stay, diet resumption, antibiotic use, ileus, transfusion, ICU admission, or mortality.

Conclusions:

  • Mechanical bowel preparation (MBP) does not influence the clinical severity of anastomotic leakage in elective rectal cancer surgery.
  • Omitting MBP may reduce the need for surgical intervention in cases of anastomotic leakage.

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