Impact of pre-operative mechanical bowel preparation in preventing post-operative anastomotic leak: A meta-analysis

Colorectal operations are amongst the most frequently performed surgical procedures worldwide. Success of colorectal surgery is significantly influenced by occurrence of postoperative complications; Efforts are directed in detecting risk factors for these complications and trials to avoid risk factors to reduce complications rate. This study was conducted to assess the impact of mechanical bowel preparation in preventing post-operative anastomotic leakage in adult patients undergoing elective restorative colorectal surgery. A Systematic review and meta-analysis of randomized controlled trials comparing patients receiving mechanical bowel preparation with those receiving no mechanical bowel preparation among adult patients undergoing laparoscopic or open elective restorative colorectal surgery. The search resulted in 1237 potentially relevant studies. Screening of titles and abstracts led to 299 studies, which were reviewed in full. Finally, 11 studies were included in the current study. number of participants in the included studies ranged from 63 to 29,739 with a mean age of 62.98 years in a range from 41 to 73 years of age. Studies featured primarily colorectal carcinoma as an indication for surgery (range 65-100 %). analysis of data was done to assess the impact of pre-operative mechanical bowel preparation on the rate of anastomotic leaks, surgical site infections, intra-abdominal collections, mortality rate, need for reoperation. and hospital length of stay. Mechanical bowel preparation appears to reduce anastomotic leaks and shorten length of hospitalization but does not significantly impact other clinical outcomes in patients undergoing elective laparoscopic or open restorative colorectal surgery.