Mechanical bowel preparation or not for elective colorectal surgery.

BACKGROUND: Mechanical bowel preparation has been a mainstay in the management of patients undergoing elective colorectal surgery, but in recent years, this practice has been challenged; and a number of clinical reports have demonstrated no benefit, as judged by reduction of surgical site infections. This paper presents the advantages and disadvantages of mechanical bowel preparation.
METHODS: Review of the pertinent English language literature.
RESULTS: Some published studies support omission of mechanical preparation of the colon prior to elective colo-rectal surgery. However, the evidence is not definitive, in that the most rigorous study performed to date, a large, randomized trial, is non-confirmatory.
CONCLUSIONS: Additional stratified studies of different mechanical bowel preparation methods, compared with no preparation, are required to address whether the practice should be abandoned.