BACKGROUND: 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. METHODS: 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. RESULTS: 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). CONCLUSION: 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.
BACKGROUND: 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. METHODS: 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. RESULTS: 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). CONCLUSION: 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.
Authors: Oded Zmora; Ahmad Mahajna; Barak Bar-Zakai; Danny Rosin; Dan Hershko; Moshe Shabtai; Michael M Krausz; Amram Ayalon Journal: Ann Surg Date: 2003-03 Impact factor: 12.969
Authors: Caroline M E Contant; Wim C J Hop; Hans Pieter van't Sant; Henk J M Oostvogel; Harm J Smeets; Laurents P S Stassen; Peter A Neijenhuis; Floris J Idenburg; Cees M Dijkhuis; Piet Heres; Willem F van Tets; Jos J G M Gerritsen; Wibo F Weidema Journal: Lancet Date: 2007-12-22 Impact factor: 79.321
Authors: Michał Pędziwiatr; Magdalena Pisarska; Michał Kisielewski; Piotr Major; Anna Mydlowska; Mateusz Rubinkiewicz; Marek Winiarski; Andrzej Budzyński Journal: Med Oncol Date: 2016-05-06 Impact factor: 3.064
Authors: Pascal H E Teeuwen; R P Bleichrodt; C Strik; J J M Groenewoud; W Brinkert; C J H M van Laarhoven; H van Goor; A J A Bremers Journal: J Gastrointest Surg Date: 2009-09-25 Impact factor: 3.452