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Is There a Role for Mechanical and Oral Antibiotic Bowel Preparation for Patients Undergoing Minimally Invasive Colorectal Surgery? A Systematic Review and Meta-analysis

  • Review Article
  • Published:
Journal of Gastrointestinal Surgery

Abstract

Introduction

To date, all meta-analyses on oral antibiotic prophylaxis (OA) and mechanical bowel preparation (MBP) in colorectal surgery have included results of both open and minimally invasive approaches. Mixing both procedures may lead to false conclusions. The aim of the study was to assess the available evidence of mechanical and oral antibiotic bowel preparation in reducing the incidence of surgical site infection (SSI) and other complications following minimally invasive elective colorectal surgery.

Methods

We searched PubMed, Science Direct, Google Scholar and Cochrane Library from 2000 to May 1, 2022. Comparative randomized and non-randomized studies were included. We reviewed the use of oral OA, MBP and combinations of these treatments. The methodological quality of the included studies was assessed using the Rob v2 and Robins-I tools.

Results

We included 18 studies (7 randomized controlled trials and 11 cohort studies). Meta-analysis of the included studies showed that the combination of MBP + OA was associated with a significant reduction in SSI, AL and overall morbidity compared with the other options no preparation, MBP only and OA only. 

Conclusion

Adding OA with MBP has a positive impact in reducing the incidence of SSI, AL and overall morbidity after minimally invasive colorectal surgery. Therefore, the combination of OA and MBP should be encouraged in this selected group of patients undergoing minimally invasive surgery.

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Data Availability

The data underlying this article will be shared on reasonable request to the corresponding author. 

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Authors and Affiliations

  1. A21 Surgery Department, Charles Nicolle Hospital, Research Laboratory LR12ES01, Faculty of Medicine of Tunis, Tunis El Manar University, Rue 9 Avril – 1007 Bab Saadoun, Tunis, Tunisia

    Mohamed Maatouk, Ghassen Hamdi Kbir, Aymen Mabrouk, Marwen Selmi, Anis Ben Dhaou, Sami daldoul, Karim Haouet & Mounir Ben Moussa

  2. Faculty of Medicine of Monastir, Monastir University, Monastir, Tunisia

    Alaa Akid

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  1. Mohamed Maatouk
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Maatouk, M., Akid, A., Kbir, G.H. et al. Is There a Role for Mechanical and Oral Antibiotic Bowel Preparation for Patients Undergoing Minimally Invasive Colorectal Surgery? A Systematic Review and Meta-analysis. J Gastrointest Surg 27, 1011–1025 (2023). https://doi.org/10.1007/s11605-023-05636-6

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