High-intensity mechanical bowel preparation before curative colorectal surgery is associated with poor long-term...

Area of Science:

• Colorectal surgery
• Surgical oncology
• Gastroenterology

Background:

• Mechanical bowel preparation (MBP) is standard practice before colorectal surgery to reduce intestinal bacteria and prevent surgical infections.
• The optimal intensity of MBP remains a subject of debate, impacting patient outcomes.

Purpose of the Study:

• To investigate the effect of different mechanical bowel preparation (MBP) intensities on progression-free survival (PFS) and overall survival (OS) in colorectal cancer (CRC) patients.
• To compare outcomes between low-intensity and high-intensity MBP in the context of colorectal cancer surgery.

Main Methods:

• A retrospective cohort study of 694 colorectal cancer (CRC) patients who underwent mechanical bowel preparation (MBP) before surgery.
• Patient survival status, disease progression, and time to death or progression were tracked via telephone follow-up until October 2018.
• Statistical analysis included Cox proportional hazard models for hazard ratios and Kaplan-Meier method with log-rank test for survival assessment.

Main Results:

• Patients receiving low-intensity MBP (n=462) demonstrated significantly higher PFS compared to those receiving high-intensity MBP (n=232) (p=0.009).
• Estimated 2000-day PFS was 69.3% for low-intensity MBP versus 58.7% for high-intensity MBP.
• Low-intensity MBP was also associated with significantly higher overall survival (OS) (p=0.009).

Conclusions:

• Low-intensity mechanical bowel preparation (MBP) is associated with improved progression-free survival (PFS) and overall survival (OS) in colorectal cancer (CRC) patients.
• These findings suggest that lower intensity MBP may be a preferable option for patients undergoing colorectal surgery.
• This study provides valuable data for clinicians selecting the appropriate intensity of MBP for colorectal cancer patients.