Single-blinded Randomized Trial of Mechanical Bowel Preparation for Colon Surgery with Primary Intraperitoneal Anastomosis

Abstract

Our final analysis shows that a single surgeon will not have a higher rate of either surgical-site infection or anastomotic failure if he/she routinely omits preoperative mechanical bowel preparation.

Mechanical bowel preparation for elective colorectal surgery: updated systematic review and meta-analysis

“…Five studies [4,6,21,23,24] reported the colonic surgery results with or without MBP. There were no statistical differences between the groups for all the outcomes considered.…”

Mechanical bowel preparation before elective colorectal surgery: is it necessary?

“…Superficial surgical site infections were more frequent in the MBP group; however, the difference was not statistically significant (MBP = 24.6%, non-MBP = 17.2%; NS). Anastomotic failure rates were also not significantly different (MBP = 6.2%, non-MBP = 4.7%; NS), supporting the omission of MBP in ECS [9]. In the RCT published by Bucher et al [10] in 2005, the infectious complications (anastomotic dehiscence and surgical site infections) were significantly higher among the patients who received MBP before ECS.…”

“…Likewise, there was no significant difference in wound infections between the two groups (difference 0.6%, 95% confidence interval 3.2-4.4%, P = 0.82). The next RCT published by Pena-Soria et al in [9] 2008 was a single-blinded randomized trial involving 129 patients (65 in MBP group). Superficial surgical site infections were more frequent in the MBP group; however, the difference was not statistically significant (MBP = 24.6%, non-MBP = 17.2%; NS).…”

Preoperative Mechanical Bowel Preparation for Abdominal, Laparoscopic, and Vaginal Surgery: A Systematic Review

“…From other surgical specialties, 23 studies met the inclusion criteria in colorectal surgery comparing MBP with no MBP: 13 RCTs (4932 patients) [57,[59][60][61][62][63][65][66][67][68][69][70][71], 2 prospective cohort studies (418 patients) [72,74], and 8 retrospective cohort studies (5141 patients) [75,78,81,[83][84][85][86]89]. All studies included only elective surgery; however, they were heterogeneous in the types of surgery performed (ileocolic, colocolic, and colorectal) and mode of surgery (laparoscopic or open surgery, or combination of both).…”

“…Among the high-quality studies evaluating patient complications, 3 studies (total 490 colorectal patients) found increased complications from MBP [59,62,66], which included increased rates of anastomotic dehiscence (p 5 .05) [62], increased infectious abdominal complications (p 5 .028) [66], and overall surgical infectious complications (20% vs 11.3%, p 5 .05) [59]. The complications were not subcategorized according to the Clavien-Dindo classification system.…”