Mechanical bowel preparation for colorectal surgery: a meta-analysis on abdominal and systemic complications on almost 5,000 patients
- First Online:
- 293 Downloads
Several studies concluded that mechanical bowel preparation (MBP) does not confer any advantage on reducing the anastomotic leak rate or wound infections. The aim of this meta-analysis was to review all prospective randomised controlled trials on the use of MBP before colorectal surgery in order to find differences in the rates of abdominal and systemic complications in view of recent published articles.
Review of all randomised prospective trials compare MBP vs. non-MBP. Primary outcome measures were anastomotic leakages, abdomino-pelvic abscesses and postoperative ileus. Secondary outcomes were wound infections, extra-abdominal complications (urinary infections, pulmonary infections, deep venous thrombosis or pulmonary embolism, cardiac events), sepsis and mortality.
Twelve articles met the inclusion criteria with 4,919 patients. The non-MBP group showed no significant increase of the anastomotic leakages (3.4% vs. 4.1%; p = NS) and wound infections (8.7% vs. 9.6%; p = NS) but had a lower rate of postoperative cardiac events (2.5% vs. 4.0%; p = 0.04).
The evidence from recent studies, combined with previous ones, further suggests that the dogma of the necessity of mechanical bowel preparation before elective colorectal surgery should be reconsidered.
KeywordsMechanical bowel preparation Colorectal surgery Anastomotic leak Wound infections Cardiovascular complications
- 1.Brownson P, Jenkins S, Nott D et al (1992) Mechanical bowel preparation before colorectal surgery: results of a prospective randomized trial [abstract]. Br J Surg 79:461–462Google Scholar
- 11.Pena-Soria MJ, Mayol JM, Anula-Fernandez R, Arbeo-Escolar A, Fernandez-Represa JA (2007) Mechanical bowel preparation for elective colorectal surgery with primary intraperitoneal anastomosis by a single surgeon: interim analysis of a prospective single-blinded randomized trial. J Gastrointest Surg 11(5):562–567PubMedCrossRefGoogle Scholar