The value of mechanical bowel preparation prior to pediatric colorectal surgery: a systematic review and meta-analysis

Lok, Maarten Janssen; O'Connell, Joshua S; Seo, Shogo; Pierro, Agostino

doi:10.1007/s00383-018-4345-y

Cited by 14 publications

(11 citation statements)

References 56 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This is in contrast to the few small, mainly retrospective, studies on mechanical bowel preparation in diverse pediatric colorectal surgery that have been published up to date. These studies showed no benefit from mechanical bowel preparation, regardless of differences in regimens used [14][15][16][17]. This is in accordance with adult literature, in which compelling evidence exists that mechanical bowel preparation alone does not protect against the occurrence of complications, e.g.…”

Section: Discussionsupporting

confidence: 88%

The impact of perioperative care on complications and short term outcome in ARM type rectovestibular fistula: An ARM-Net consortium study

Steeg

Rooij

Iacobelli

et al. 2019

Journal of Pediatric Surgery

View full text Add to dashboard Cite

Section: Discussionsupporting

confidence: 88%

The impact of perioperative care on complications and short term outcome in ARM type rectovestibular fistula: An ARM-Net consortium study

Steeg

Rooij

Iacobelli

et al. 2019

Journal of Pediatric Surgery

View full text Add to dashboard Cite

“…A systematic review and meta-analysis by Lok et al analyzed the possible effect of mechanical bowel preparation in pediatric patients who underwent colorectal surgeries. 9 This study included 6 low-quality studies with high randomization bias and confounding factors such as antibiotic administrations and varying amount of colorectal procedures. It was concluded that mechanical bowel preparation did not reduce the rate of anastomosis leakage and surgical site infection.…”

Section: Resultsmentioning

confidence: 99%

“…19 Moreover, hard and solid feces can be prevented by this preparation as well. 9,10,12 Therefore, most surgeons still consider bowel preparation to assure safety colorectal surgical procedures. 19 Bowel preparation can be administered by several routes (orally and rectally) without any prior international standardization.…”

Section: Discussionmentioning

confidence: 99%

Bowel Preparation in Pediatric Colorectal Surgery, Can We Move On? Historical and Literature Review

Rinaldhy

Wisnu

Widyani

et al. 2022

Arch Pediatr Gastr Hepatol Nutr

View full text Add to dashboard Cite

Background: Surgical procedure in colorectal cases have a high morbidity rate; in pediatric population, surgical site infection occurs in more than 13% of patients undergoing elective colorectal surgery. Bowel preparation is believed to decrease infection rate by removing feces from colorectal. This procedure has been routinely performed despite the lack of clear evidence and the invasive nature of the procedure. In pediatric population, the evidence is scarce with varying qualities, thus this study aims to evaluate the effect of bowel preparation on pediatric population. Methods: We conducted a comprehensive literature review from PubMed and cross-referencing articles. Six full-text studies presenting bowel preparation in pediatric colorectal surgeries were included in the analysis. Results: Majority of studies we analyzed showed no association between bowel preparation and surgical site infections. They also showed the lack of correlation between the procedure and post-operative complication. Discussion: Bowel preparation was quickly adapted by surgeons due to its theoretical effect, but current evidence showed no clear benefit in doing so. In pediatric cases, the evidence is scarce and variable, and with the risk associated, surgeons should consider carefully before conducting bowel preparation in pediatric patients. Conclusion: Bowel preparation does not significantly decrease post-operative morbidities, such as anastomosis leakage, intrabdominal infection, and surgical wound infection.

show abstract

“…Mechanical and oral antibiotic bowel preparation (MOABP) prior to colorectal surgery was thought necessary to remove feces from the large intestine, reduce the bacterial load in the lumen, and decrease surgical site infection (SSI) (1) or other postoperative complications (2,3). However, doubts about the benefit of mechanical bowel preparation (MBP) in adults have been raised (4)(5)(6)(7)(8)(9)(10)(11), and the randomized clinical trials, systematic reviews and meta-analyses of preoperative MBP in adults have concluded that it can be safely omitted (12)(13)(14).…”

Section: Introductionmentioning

confidence: 99%

“…The benefit of MBP in children is still unclear because of the paucity of clinical evidencebased studies in general (15,16). Several small studies done in pediatric elective colorectal surgical patients have found no differences in SSI incidence or other postoperative complications in pediatric patients who underwent MBP or not (2,15,(17)(18)(19). But the current trend in pediatric hospitals continues to favor use of MBP (17,20).…”

Section: Introductionmentioning

confidence: 99%

Role of mechanical and oral antibiotic bowel preparation in children with Hirschsprung’s disease undergoing colostomy closure and pull-through

Liang¹,

Xin²,

Liu³

et al. 2021

Transl Pediatr

View full text Add to dashboard Cite

Background: Mechanical and oral antibiotic bowel preparation (MOABP) has been performed routinely before colorectal surgery in children, but the necessity was questioned recently. We evaluated the utility of MOABP in children with Hirschsprung's disease (HSCR) undergoing colostomy closure and pull-through. Methods:The medical records of pediatric patients with HSCR who underwent colostomy closure and pull-through in a single center from January 2010 to January 2020 were reviewed. The use of MOABP was noted. The incidence of postoperative complications, duration of postoperative antibiotic therapy, total hospital cost and length-of-stay were compared between patients receiving MOABP and no bowel preparation (NBP).Results: A total of 64 patients were included in the study: 33 received MOABP and 31 had NBP. The respective postoperative complications in the MOABP and NBP groups were: intra-abdominal infection (18.2% vs. 29.0%), wound infection (9.1% vs. 16.1%), anastomotic leak (0 vs. 0), intestinal obstruction (6.1% vs. 0) and enterocolitis (3.03% vs. 12.90%). The duration of antibiotic therapy was 4.91±4.21 and 5.23±3.77 days (P=0.75) and hospitalization was 18.21±7.26 and 16.26±6.63 days (P=0.27) respectively.The total hospital cost in the MOABP group (4,720.14±1,858.89 USD) was higher than in the NBP group (3,749.06±2,009.97 USD) (P=0.049). Conclusions:We did not find any clear benefit of MOABP in children with HSCR before colostomy closure and pull-through. However, a multicenter randomized controlled trial is needed to more definitely determine the best preoperative approach for children with HSCR.

show abstract

The value of mechanical bowel preparation prior to pediatric colorectal surgery: a systematic review and meta-analysis

Cited by 14 publications

References 56 publications

The impact of perioperative care on complications and short term outcome in ARM type rectovestibular fistula: An ARM-Net consortium study

The impact of perioperative care on complications and short term outcome in ARM type rectovestibular fistula: An ARM-Net consortium study

Bowel Preparation in Pediatric Colorectal Surgery, Can We Move On? Historical and Literature Review

Role of mechanical and oral antibiotic bowel preparation in children with Hirschsprung’s disease undergoing colostomy closure and pull-through

Contact Info

Product

Resources

About