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Mechanical Bowel Preparation for Elective Colon and Rectal Surgery

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Clinical Decision Making in Colorectal Surgery

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Abstract

Infectious complications commonly occur following colon and rectal surgery, resulting in significant morbidity, increased cost, prolonged hospital stay, and mortality. Although modern surgical techniques improved perioperative care, and powerful antibiotics for the control of sepsis have all decreased mortality, surgical site infectious complications remain a major source of morbidity. In the past, the use of bowel preparation prior to an elective colorectal surgery was the standard of care aiming to clear the bowel of fecal matter and reduce the bacterial count in the colon lumen. However, randomized controlled trials showed no difference in postoperative outcomes with the use of mechanical bowel preparation compared to no bowel preparation. Recent data suggest that the use of mechanical bowel preparation with oral antibiotics may be associated with reduced risk of postoperative complications. These data raise once again the debate of whether or not to prescribe preoperative bowel preparation. This chapter reviews the current literature regarding mechanical bowel preparation for elective colon and rectal surgery and assess whether the routine use of mechanical bowel preparation is of benefit in this setting.

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Author information

Authors and Affiliations

  1. Department of Surgery, Sheba Medical Center, Tel Aviv, Israel

    Chaya Shwaartz

  2. Department of Surgery, Shamir Medical Center (Assaf Harofe), Tel Aviv, Israel

    Oded Zmora

  3. Department of Surgery, Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel

    Oded Zmora

Authors
  1. Chaya Shwaartz
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  2. Oded Zmora
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Correspondence to Oded Zmora .

Editor information

Editors and Affiliations

  1. Department of Colorectal Surgery, Cleveland Clinic, Cleveland, OH, USA

    Scott R. Steele

  2. Department of Surgery, University of Massachusetts, Worcester, MA, USA

    Justin A. Maykel

  3. Department of Colorectal Surgery, Cleveland Clinic Florida, Weston, FL, USA

    Steven D. Wexner

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Shwaartz, C., Zmora, O. (2020). Mechanical Bowel Preparation for Elective Colon and Rectal Surgery. In: Steele, S., Maykel, J., Wexner, S. (eds) Clinical Decision Making in Colorectal Surgery. Springer, Cham. https://doi.org/10.1007/978-3-319-65942-8_4

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  • DOI: https://doi.org/10.1007/978-3-319-65942-8_4

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  • Online ISBN: 978-3-319-65942-8

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