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  1. Home
  3. Preoperative Mechanical Bowel Preparation Versus No Preparation For Pediatric Intestinal Surgery: A Systematic Review And Meta-analysis.
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  3. Preoperative Mechanical Bowel Preparation Versus No Preparation For Pediatric Intestinal Surgery: A Systematic Review And Meta-analysis.

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Preoperative mechanical bowel preparation versus no preparation for pediatric intestinal surgery: a systematic review

Rajpal Singh Sisodiya1, Prince Raj2, Akanksha Tomar3

  • 1Department of Pediatric Surgery, Netaji Subhash Chandra Bose Medical College, Jabalpur, Madhya Pradesh, India. rssisodiyanscbpediasurgery@gmail.com.

Pediatric Surgery International
|December 6, 2025

View abstract on PubMed

Summary
This summary is machine-generated.

Mechanical bowel preparation (MBP) before pediatric intestinal surgery does not reduce infection risk and may prolong recovery. Routine MBP is likely unnecessary, but specific cases may still require it.

Keywords:
Anastomotic leakColostomy closureIntra-abdominal abscessMechanical bowel preparationPediatric intestinal surgerySurgical site infectionSystematic review and meta-analysis

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Area of Science:

  • Pediatric Surgery
  • Gastrointestinal Surgery
  • Evidence-Based Medicine

Background:

  • Mechanical bowel preparation (MBP) is traditionally used in pediatric intestinal surgery, aiming to decrease infection risk.
  • Adult studies suggest benefits only when MBP is combined with oral antibiotics, but pediatric evidence is inconsistent.

Purpose of the Study:

  • To systematically review and meta-analyze the efficacy of MBP in pediatric elective intestinal surgery.
  • To evaluate MBP's impact on surgical site infections (SSI), anastomotic leaks (AL), and intra-abdominal abscesses (IAA).

Main Methods:

  • Systematic review and meta-analysis of randomized controlled trials and comparative observational cohorts.
  • Searched databases up to August 2025, including 17 studies with 3,036 children.
  • Assessed outcomes including SSI, AL, IAA, ileus, bowel obstruction, and length of stay (LOS) using random-effects models and GRADE certainty assessment.

    • Main Results:

    • MBP did not reduce the incidence of SSI, AL, or IAA.
    • Moderate certainty for SSI and low certainty for AL/IAA outcomes.
    • MBP was associated with a longer length of stay and potential non-significant increases in ileus and bowel obstruction.

    Conclusions:

    • Current evidence indicates no significant benefit of MBP in pediatric elective intestinal surgery.
    • Routine MBP may delay patient recovery and appears unnecessary within Enhanced Recovery After Surgery (ERAS) protocols.
    • Further high-quality multicenter trials are needed to definitively assess MBP's role, though it may be indicated for specific functional or reconstructive reasons.