Reappraisal of preoperative bowel preparation in colorectal surgery

For over a century, mechanical bowel preparation prior to elective colorectal surgery is a time – honored dogma. However, this dogma is based on experience and observation only. Challenges of this dogma began when surgeon started performing primary repair of colonic injury in trauma case with good results. This review aims to evaluate the evidence for and against the use of mechanical bowel preparation in elective colorectal surgery. A literature search was done on Pubmed and Medline in recent 10 years, and emphasis was put on randomized controlled trial and meta-analysis. It is concluded that there is no statistical evidence that patients significantly benefit from mechanical bowel preparation. Thus the routine use of mechanical bowel preparation in elective colorectal surgery should be reconsidered. Keywords: mechanical bowel preparation, colorectal surgery For over a century, mechanical bowel preparation prior to elective colorectal surgery is a time – honored dogma. However, this dogma is based on experience and observation only. Challenges of this dogma began when surgeon started performing primary repair of colonic injury in trauma case with good results. This review aims to evaluate the evidence for and against the use of mechanical bowel preparation in elective colorectal surgery. A literature search was done on Pubmed and Medline in recent 10 years, and emphasis was put on randomized controlled trial and meta-analysis. It is concluded that there is no statistical evidence that patients significantly benefit from mechanical bowel preparation. Thus the routine use of mechanical bowel preparation in elective colorectal surgery should be reconsidered. Key words: mechanical bowel preparation, colorectal surgery