8
Views
4
CrossRef citations to date
0
Altmetric
Original Papers

Elective Colorectal Surgery without Bowel Preparation: a Historical Control and Case-Matched Study

, , &
Pages 52-55 | Published online: 11 Mar 2016
 

Abstract

Background: Although full bowel preparation, including mechanical washout and non-absorbable anti-biotherapy, has been considered for decades as a prerequisite to any elective colorectal surgery, recent literature has suggested that this habit was perhaps unjustified. The aim of this study was to assess the safety of ileocolic, colocolic and colorectal anastomosis in the absence of pre-operative mechanical bowel preparation.

Methods: During a 1-year period, 59 consecutive patients underwent elective colorectal surgery with ileocolic, colocolic or colorectal anastomosis without any pre-operative preparation. This “non-prepared group” (NPG) was compared to a “control group” (CG) composed of the previous 127 consecutive cases of classically managed patients. To improve the statistical power we also compared the NPG to a “match-controlled group” (MCG) of 59 patients within the CG. Primary end-points were anastomotic leakage and abdominal infections. Secondary end-points were oral diet resume time and hospital stay.

Results: There were no differences between the 3 groups for age, gender, BMI, immunodepression status, anastomosis site and suture technique.

There were no differences between NPG and CG or MCG for anastomotic leakage (3.5%, 4.7% and 6.8% respectively, NPG/CG p = 0.68 and NPG/MCG p = 0.4) or for infectious abdominal complications.

Mean diet resume time was 1.4 (1–5) days in the NPG versus 3.4 (1–19) days in the CG and 3.1 (1–6) days in the MCG (p < 0.00001).

Median length of postoperative hospital stay was 5 (2–81) days in the NPG versus 8 (4–100) and 8 (4–100) in the CG and the MCG respectively.

Conclusions: In accordance with the recent literature, the present experience does not show any benefit of mechanical bowel preparation in elective colorectal resection. This suggests that bowel preparation could be omitted before this type of surgery.

Additional information

Notes on contributors

D. Pitot

Clinic of Colorectal Surgery Department of Digestive Surgery Hôpital Erasme – ULB 808 route de Lennik B-1070 Brussels, Belgium E-mail: [email protected]

Reprints and Corporate Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

To request a reprint or corporate permissions for this article, please click on the relevant link below:

Academic Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

Obtain permissions instantly via Rightslink by clicking on the button below:

If you are unable to obtain permissions via Rightslink, please complete and submit this Permissions form. For more information, please visit our Permissions help page.