TREATMENT
Review: mechanical bowel preparation before colorectal surgery does not provide any benefit and may be harmful
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Does mechanical bowel preparation (MBP) before colorectal surgery provide any benefit?
Included studies compared MBP with no MBP before elective colorectal surgery for malignant or benign conditions. Outcomes included anastomotic leakage, pelvic or abdominal abscess, and surgical site infection.
Medline, Scopus, and Cochrane Library (to Jan 2008); recent issues of major surgical journals; proceedings of major meetings; and reference lists were searched for randomised controlled trials (RCTs). 14 RCTs (n = 4859) met the selection criteria. All but 1 trial enrolled only adults.
Groups did not differ for anastomotic leakage or pelvic or abdominal abscess (table). Surgical site infections were more frequent in the MBP group (table). Relative risks of adverse outcomes were similar whether polyethylene glycol (9 RCTs, n = 3619) or sodium phosphate (4 RCTs, n = 2253) was the solution used.
Mechanical bowel preparation before colorectal surgery does not provide any benefit but may increase risk of
University of Worcester, Worcester, UK
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