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Optimizing Preoperative Care: Comparing Mechanical Bowel Preparation Alone Versus Combined Oral Antibiotics in

Kainaat Salaria1, Yamin Manzoor Bhat1, Imad Banday1

  • 1Department of General and Minimal Invasive Surgery, Sher-I-Kashmir Institute of Medical Sciences, Soura, Srinagar India.

Indian Journal of Surgical Oncology
|November 24, 2025
PubMed

Insights

Adding oral antibiotics to mechanical bowel preparation significantly reduces surgical site infections and anastomotic leaks in colorectal cancer surgeries. This combination enhances patient safety and improves surgical outcomes compared to mechanical bowel preparation alone.

Area of Science:

  • Colorectal Surgery
  • Surgical Oncology
  • Infectious Disease Prevention

Background:

  • Mechanical bowel preparation (MBP) is standard practice in colorectal surgery to reduce postoperative complications, but its efficacy is debated.
  • Combining MBP with oral antibiotics (OA) may further decrease surgical site infections (SSIs) and anastomotic leaks, especially in high-risk procedures.

Purpose of the Study:

  • To compare the effectiveness of MBP alone versus MBP with OA in reducing SSIs, anastomotic leaks, and other postoperative complications in elective colorectal surgeries.

Main Methods:

  • A quasi-experimental study involving 99 patients undergoing colorectal cancer surgery.
  • Patients were divided into two groups: Group A (n=33) received MBP alone, and Group B (n=66) received MBP with rifaximin (OA).
  • Postoperative outcomes including SSIs, anastomotic leaks, ileus, and mortality were assessed, with statistical significance set at p < 0.05.

Main Results:

  • Group B showed significantly lower rates of SSIs (9% vs. 18%, p=0.045) and anastomotic leaks (7.5% vs. 12%, p=0.039) compared to Group A.
  • No significant differences were found in ileus or mortality rates between the groups.
  • No patients required readmission, and MBP was generally well-tolerated.

Conclusions:

  • The combination of MBP and OA significantly reduces SSIs and anastomotic leaks in elective colorectal surgeries.
  • Integrating OA into preoperative protocols enhances surgical outcomes and patient safety for colorectal cancer surgeries without increasing adverse events.
Keywords:
Colorectal cancerMechanical bowel preparationOral antibioticsOutcomesPostoperative complicationsSSIs

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