Preoperative bowel preparation
A survey of 500 clinically active, board-certified colon and rectal surgeons in the United States and Canada was conducted to obtain data regarding current methods of bowel preparation for elective colorectal surgery. A review of recent publications on preoperative bowel preparation was used to compare the current literature recommendations with the actual practice among the group surveyed. Responses were received from 352 of 500 colorectal surgeons to whom questionnaires were sent (70 percent response rate). All respondents used a mechanical preparation and some form of antibiotics. The favorite antibiotic regimen was oral antimicrobials combined with systemic antibiotics (88 percent). Concomitant administration of oral neomycin-erythromycin base and a systemic second generation cephalosporin active against both anaerobic and aerobic colonic bacteria, together with oral polyethelene glycol electrolyte mechanical colonic cleansing, was the most popular method of preoperative bowel preparation (58 percent). The second most frequent method of mechanical bowel cleansing consisted of conventional enemas, dietary restrictions, and cathartic preparations (36 percent). Mannitol solution (5 percent), and whole-gut irrigation per nasogastric tube (1 percent) were the least popular methods of mechanical bowel cleansing. The literature supports the current methods of preoperative bowel preparation used by the vast majority of surgeons surveyed.
Key wordsBowel preparation colonic cleansing Prophylactic antibiotics
Unable to display preview. Download preview PDF.
- 1.Nichols RL, Condon RE. Preoperative preparation of the colon. Surg Gynecol Obstet 1971;132:323–37.Google Scholar
- 9.Gottrup F, Diederich P, Sorensen K, Nielsen SV, Ornsholt J, Brandsborg O. Prophylaxis with whole-gut irrigation and antimicrobials in colorectal surgery: a prospective, randomized double-blind clinical trial.Google Scholar
- 12.Jagelman DG, Fazio VW, Lavery IC, Weakley FL. A prospective, randomized, double blind study of 10% mannitol mechanical bowel preparation combined with oral neomycin and shortterm, preoperative, intravenous flagyl as prophylaxis in elective colorectal resections. Surgery 1985;98:861–5.PubMedGoogle Scholar
- 24.The Norwegian study group for colorectal surgery. Surgery 1985;94:402–8.Google Scholar
- 36.Condon RE, Bartlett JG, Nichols RL, Schulte WJ, Gorbach SL, Ochi S. Preoperative prophylactic cephalothin fails to control septic complications of colorectal operations: results of controlled clinical trial. A Veterans Administration cooperative study. Am J Surg 1979;137:58–74.Google Scholar
- 38.Condon RE. Antibiotic bowel preparation for surgery. Confronting Infection, Cases and Commentary. Wilmington: Stuart Pharmaceuticals, 1987;5:1–12.Google Scholar
- 41.Eisenberg HW. The use of new antibiotics in colorectal surgery. Am J Proctol 1981;32:9–26.Google Scholar