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Is mechanical bowel preparation necessary in bariatric surgery?

Jesse Gray1, Stephen D Helmer1, Karson R Quinn1

  • 1Department of Surgery, University of Kansas School of Medicine-Wichita, Wichita, KS, USA.

American Journal of Surgery
|February 1, 2022
PubMed
Abstract

Insights

Mechanical bowel preparation (MBP) is not necessary before bariatric surgery. A study found no significant difference in complications or outcomes between patients who had MBP and those who did not, suggesting it can be safely omitted.

Area of Science:

  • Bariatric Surgery
  • Surgical Outcomes
  • Gastrointestinal Surgery

Background:

  • Historically, mechanical bowel preparation (MBP) has been standard practice before bariatric procedures.
  • Colorectal surgery has demonstrated that no-MBP is non-inferior to MBP regarding postoperative complications.
  • This study aimed to evaluate the non-inferiority of no-MBP in bariatric surgery.

Purpose of the Study:

  • To demonstrate that omitting mechanical bowel preparation (MBP) prior to bariatric surgery is non-inferior to performing MBP.
  • To compare postoperative complication rates between bariatric surgery patients who underwent MBP versus those who did not.

Main Methods:

  • A prospective, randomized, controlled trial was conducted.
  • Patients undergoing Roux-en-Y Gastric Bypass or Sleeve Gastrectomy were randomized to either MBP or no-MBP.
  • Postoperative complications, readmissions, and wound infections within 30 days were recorded.

Main Results:

  • A total of 139 patients were enrolled (71 in MBP group, 68 in no-MBP group).
  • Complication rates were similar between groups (12.7% vs. 10.2%, p=0.660).
  • Median hospital stay (1 day vs. 1 day, p=0.782) and readmission rates (4.4% vs. 5.6%, p=1.000) were also similar.

Conclusions:

  • Mechanical bowel preparation is likely not necessary prior to bariatric procedures.
  • Omitting MBP in bariatric surgery does not increase postoperative complications or negatively impact outcomes.
  • This finding supports a potential change in standard surgical protocols for bariatric procedures.
Keywords:
Bariatric surgeryComplicationMechanical bowel preparationRoux-en-Y gastric bypassSleeve gastrectomy

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