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Techniques in Coloproctology

, Volume 15, Supplement 1, pp 59–62 | Cite as

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

  • A. MatsouEmail author
  • G. Vrakas
  • M. Doulgerakis
  • K. Hatzimisios
  • N. Zandes
  • K. Saliangas
Article

Abstract

Aim

To present the worldwide accepted guidelines concerning the use of mechanical bowel preparation (MBP) before elective colorectal surgery (ECS).

Patients and methods

We conducted a retrospective review of the Pubmed Databases for randomized controlled trials (RCTs) and meta-analyses, which included adult patients who underwent elective colorectal surgery. We compared the patients who had a preoperative MBP with those who did not. Significant factors that were taken into account were postoperative septic complications and anastomotic dehiscence.

Results

Our search revealed 5 RCTs and 2 meta-analyses that met our criteria. Patients who underwent emergency colorectal surgery were excluded from the study. We identified the recommendations for 6 different types of elective colorectal surgery.

Conclusion

MBP has been for many years a standard clinical procedure for patients undergoing elective colorectal surgery. However, many recent researches suggest the omission of MBP, since there are no significant differences regarding postoperative infectious complications, such as anastomotic dehiscence and superficial surgical site infections. Furthermore, MBP is a time-consuming, expensive procedure and causes severe discomfort to the patient. More importantly, the application of MBP has been associated with serious complications in both healthy patients and patients with existing cardiac or renal disease, such as electrolyte and volume disturbances.

Keywords

Mechanical bowel preparation (MBP) Elective colorectal surgery (ECS) Anastomotic dehiscence 

Notes

Conflict of interest

The authors declare that they have no conflict of interest related to the publication of this article.

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Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • A. Matsou
    • 2
    • 1
    Email author
  • G. Vrakas
    • 1
  • M. Doulgerakis
    • 1
  • K. Hatzimisios
    • 1
  • N. Zandes
    • 1
  • K. Saliangas
    • 1
  1. 1.Surgical DepartmentGeneral District Hospital “Mamatseio”KozaniGreece
  2. 2.ThessalonikiGreece

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