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Updated: Jun 28, 2025
Murine Ileocolic Bowel Resection with Primary Anastomosis
Published on: October 29, 2014
The effect of preoperative mechanical bowel preparation in paediatric bowel surgery on postoperative wound related
Meixue Chen1, Jin Lin2, Dongrong Miao1
1Department of Pediatrics, Dongguan Maternal and Child Health Care Hospital, Dongguan, China.
Insights
Mechanical bowel preparation (MBP) before pediatric bowel surgery does not reduce postoperative complications. This systematic review found no significant difference in infection or anastomotic leak rates, suggesting MBP may be unnecessary for elective procedures.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Nursing Research
Background:
- Mechanical bowel preparation (MBP) is a common pre-surgical procedure for pediatric bowel surgery.
- Its necessity and impact on postoperative outcomes remain debated in clinical practice.
Purpose of the Study:
- To systematically review and meta-analyze the effect of preoperative MBP on wound-related complications in pediatric bowel surgery.
- To evaluate the clinical value of MBP in this patient population.
Main Methods:
- Systematic review and meta-analysis of 11 studies (2556 patients) from four databases (PubMed, Embase, Web of Science, Cochrane Library) up to November 2023.
- Quality assessment using ROBINS-I and data analysis using RevMan5.3 with fixed- or random-effect models.
- Analyzed outcomes including wound infection, intra-abdominal infection, anastomotic leak, anastomotic dehiscence, and intestinal obstruction.
Main Results:
- No statistically significant difference was found in wound infection (OR 1.11), intra-abdominal infection (OR 1.26), anastomotic leak (OR 1.07), or anastomotic dehiscence (OR 1.67) between MBP and no MBP groups.
- MBP did not show an advantage in preventing intestinal obstruction (OR 1.95).
- Most included studies had moderate-to-severe risk of bias.
Conclusions:
- Current evidence suggests preoperative MBP does not reduce the risk of postoperative wound complications in children undergoing elective bowel surgery.
- MBP may be unnecessary for elective pediatric bowel surgery, but findings require cautious interpretation due to limited sample size and low evidence quality.
- Further high-quality, large-scale, multicenter trials are recommended to validate these findings.
Abstract:
Mechanical bowel preparation (MBP), a routine nursing procedure before paediatric bowel surgery, is widely should in clinical practice, but its necessity remains controversial. In a systematic review and meta-analysis, we evaluated the effect of preoperative MBP in paediatric bowel surgery on postoperative wound-related complications in order to analyse the clinical application value of MBP in paediatric bowel surgery. As of November 2023, we searched four online databases: the Cochrane Library, Embase, PubMed, and Web of Science. Two investigators screened the collected studies against inclusion and exclusion criteria, and ROBINS-I was used to evaluate the quality of studies. Using RevMan5.3, a meta-analysis of the collected data was performed, and a fixed-effect model or a random-effect model was used to analyse OR, 95% CI, SMD, and MD. A total of 11 studies with 2556 patients were included. Most of studies had moderate-to-severe quality bias. The results of meta-analysis showed no statistically significant difference in the incidence of complications related to postoperative infections in children with MBP before bowel surgery versus those with No MBP, wound infection (OR 1.11, 95% CI:0.76 ~ 1.61, p = 0.59, I2 = 5%), intra-abdominal infection (OR 1.26, 95% CI:0.58 ~ 2.77, p = 0.56, I2 = 9%). There was no significant difference in the risk of postoperative bowel anastomotic leak (OR 1.07, 95% CI:0.68 ~ 1.68, p = 0.78, I2 = 12%), and anastomotic dehiscence (OR 1.67, 95% CI:0.13 ~ 22.20, p = 0.70, I2 = 73%). Patients' intestinal obstruction did not show an advantage of undergoing MBP preoperatively, with an incidence of intestinal obstruction (OR 1.95, 95% CI:0.55 ~ 6.93, p = 0.30, I2 = 0%). Based on existing evidence that preoperative MBP in paediatric bowel surgery did not reduce the risk of postoperative wound complications, we cautiously assume that MBP before surgery is unnecessary for children undergoing elective bowel surgery. However, due to the limited number of study participants selected for this study and the overall low quality of evidence, the results need to be interpreted with caution. It is suggested that more high quality, large-sample, multicenter clinical trials are required to validate our findings.
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