Mechanical bowel preparation for elective colorectal surgery

Guenaga, Katia KFG; Atallah, Álvaro Nagib; Castro, Aldemar Araújo; Matos, Délcio; Wille‐Jørgensen, Peer

doi:10.1002/14651858.cd001544.pub2

Cited by 156 publications

(111 citation statements)

References 23 publications

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“…The more recent trials of Miettinen et al 17 and Zmora et al 8 have well-defined trial designs but have the persistent problem of lack of statistical power and heterogeneity of the inclusion group. Recent meta-analysis of Slim et al 25 (that included abstract data of the present trial), Bucher et al, 26 and Guenaga et al 27 there are significantly more anastomotic leakages after MBP compared with a no-preparation regimen. Other end points like wound infection also favored the no-preparation groups.…”

Section: Discussionmentioning

confidence: 62%

Mechanical Bowel Preparation or Not? Outcome of a Multicenter, Randomized Trial in Elective Open Colon Surgery

Fa-Si-Oen

Roumen

Buitenweg

et al. 2005

Diseases of the Colon &Amp; Rectum

162

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In the present study we could not detect a difference in outcome parameters between patients receiving mechanical bowel preparation in elective open colon surgery and patients without preoperative treatment of the bowel. The present study, although underpowered, did not show a difference in the primary outcome of bacterial wound cultures between patients receiving preoperative mechanical bowel preparation and patients receiving no preoperative bowel treatment. We conclude that there may be no need to continue the use of mechanical bowel preparation in elective open colon surgery.

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Section: Discussionmentioning

confidence: 62%

Mechanical Bowel Preparation or Not? Outcome of a Multicenter, Randomized Trial in Elective Open Colon Surgery

Fa-Si-Oen

Roumen

Buitenweg

et al. 2005

Diseases of the Colon &Amp; Rectum

162

View full text Add to dashboard Cite

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“…54 A Cochrane Database review of nine randomized prospective trials found no convincing evidence that bowel preparation is associated with reduced rates of leakage and that its use should be reconsidered. 55 …”

Section: Bowel Preparationmentioning

confidence: 99%

Anastomotic leakage after low anterior resection for rectal cancer: Facts, obscurity, and fiction

2009

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The subject of anastomotic leakage after low anterior resection (LAR) for rectal cancer remains controversial. Risk factors have been discussed in several studies but the findings are often inconclusive. This review evaluates these studies and separates the known risk factors into those that are well documented, those that are obsolete, and those that require further research. We searched the Medline and PubMed databases using the keywords: "leakage," "low anterior resection," "rectal cancer," "risk factors," and their combinations. There were no language or publication year restrictions. References in published papers were also reviewed. Each risk factor was evaluated and discussed separately. The evidence suggests that low anastomoses are more prone to leakage. Other well-documented risk factors are male sex, smoking, and preoperative malnutrition. Routine mobilization of the splenic flexure and the use of a J-pouch seem to reduce the leakage rate. The effect of preoperative chemo-radiotherapy is under scrutiny. The indications for a protective stoma remain debatable. Omentoplasty, bowel preparation, the use of a drain, and tumor stage do not seem to affect the leakage rate. The type of operation (open or laparoscopic) and anastomosis (hand-sewn or stapled) is not crucial.

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“…However, current literature does not always concur with actual practice. Despite the findings of several studies that PBP has no benefit in rectal surgery, most surgeons apply PBP routinely for different reasons [14,15,17,19]. In this respect, reduction of intestinal volume to facilitate laparoscopic exposure appeared to be a specific incentive.…”

Section: Discussionmentioning

confidence: 96%

Current technique of laparoscopic total mesorectal excision (TME): an international questionnaire among 368 surgeons

et al. 2009

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Mechanical bowel preparation for elective colorectal surgery

Cited by 156 publications

References 23 publications

Mechanical Bowel Preparation or Not? Outcome of a Multicenter, Randomized Trial in Elective Open Colon Surgery

Mechanical Bowel Preparation or Not? Outcome of a Multicenter, Randomized Trial in Elective Open Colon Surgery

Anastomotic leakage after low anterior resection for rectal cancer: Facts, obscurity, and fiction

Current technique of laparoscopic total mesorectal excision (TME): an international questionnaire among 368 surgeons

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