The American Society of Colon and Rectal Surgeons Clinical Practice Guidelines for the Use of Bowel Preparation in Elective Colon and Rectal Surgery

Migaly, John; Bafford, Andrea C; Francone, Todd D.; Gaertner, Wolfgang B.; Eskicioglu, Cagla; Bordeianou, Liliana; Feingold, Daniel L.; Steele, Scott R.; Surgeons, Rectal

doi:10.1097/dcr.0000000000001238

Cited by 131 publications

(79 citation statements)

References 36 publications

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“…Hence, most surgical scientific organizations have issued guidelines against the use of MBP. WHO SSI prevention guidelines, NICE guidelines of 2019, the guidelines of the American Society of Colon and Rectal Surgeons (ASCRS), and those of the Canadian Society of Colon and Rectal Surgeons (CSRS), the RCOG and the ACOG, advise against the sole use of mechanical bowel preparation [29][30][31][32][33][34]. To our knowledge, the use of MBP is not recommended by any scientific body, prior to minimally invasive or vaginal gynecologic surgery.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Preoperative Bowel Preparation in Minimally Invasive and Vaginal Gynecologic Surgery

Diakosavvas

Thomakos

Psarris

et al. 2020

The Scientific World Journal

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Bowel preparation traditionally refers to the removal of bowel contents via mechanical cleansing measures. Although it has been a common practice for more than 70 years, its use is based mostly on expert opinion rather than solid evidence. Mechanical bowel preparation in minimally invasive and vaginal gynecologic surgery is strongly debated, since many studies have not confirmed its effectiveness, neither in reducing postoperative infectious morbidity nor in improving surgeons’ performance. A comprehensive search of Medline/PubMed and the Cochrane Library Database was conducted, for related articles up to June 2019, including terms such as “mechanical bowel preparation,” “vaginal surgery,” “minimally invasive,” and “gynecology.” We aimed to determine the best practice regarding bowel preparation before these surgical approaches. In previous studies, bowel preparation was evaluated only via mechanical measures. The identified randomized trials in laparoscopic approach and in vaginal surgery were 8 and 4, respectively. Most of them compare different types of preparation, with patients being separated into groups of oral laxatives, rectal measures (enema), low residue diet, and fasting. The outcomes of interest are the quality of the surgical field, postoperative infectious complications, length of hospital stay, and patients’ comfort during the whole procedure. The results are almost identical regardless of the procedure’s type. Routine administration of bowel preparation seems to offer no advantage to any of the objectives mentioned above. Taking into consideration the fact that in most gynecologic cases there is minimal probability of bowel intraluminal entry and, thus, low surgical site infection rates, most scientific societies have issued guidelines against the use of any bowel preparation regimen before laparoscopic or vaginal surgery. Nonetheless, surgeons still do not use a specific pattern and continue ordering them. However, according to recent evidence, preoperative bowel preparation of any type should be omitted prior to minimally invasive and vaginal gynecologic surgeries.

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Section: Discussionmentioning

confidence: 99%

“…erefore, some scientific societies that take these recent data into account have issued complimentary recommendations suggesting that MBP use in conjunction with OABP is the safer approach, at least in colorectal surgery [29,31].…”

Section: Discussionmentioning

confidence: 99%

Preoperative Bowel Preparation in Minimally Invasive and Vaginal Gynecologic Surgery

Diakosavvas

Thomakos

Psarris

et al. 2020

The Scientific World Journal

View full text Add to dashboard Cite

show abstract

“…Omitting both mechanical and antibiotic bowel preparation in RC with small bowel urinary diversions has demonstrated no difference in terms of gastrointestinal (GI) complications and wound infections . Based on colorectal literature, it is recommended that patients undergo mechanical and chemical bowel preparations for diversions using the colon …”

Section: Preoperative Componentsmentioning

confidence: 99%

“…Antimicrobial coverage should include aerobic and anaerobic bacteria for patients undergoing bowel resection. A second or third generation cephalosporin or, alternatively, use of an aminoglycoside in combination with metronidazole or clindamycin is recommended to be administered within 1 h prior to skin incision . In prolonged surgeries and in surgeries with increased blood loss, repeated dosages every 3‐4 hours are beneficial, depending on the half‐life of the drug .…”

Section: Preoperative Componentsmentioning

confidence: 99%

Enhanced recovery after surgery review and urology applications in 2020

Pessôa¹,

Ürkmez

Kukreja

et al. 2020

BJUI Compass

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Purpose: To explore enhanced recovery after surgery (ERAS) components and their current application to major urologic surgeries, barriers to implementation and maintenance of the associated quality improvement. Data Identification: An English language literature search was done using PubMed. Study Selection: After independent review, 55 of the original 214 articles were selected to specifically address the stated purpose. Data Extraction: Clinical trials were included, randomized trials were prioritized, but robust observational studies were also included. Results of Data Synthesis: Many ERAS components have good data to support usage in radical cystectomy (RC) patients. Most ERAS programs include multidisciplinary teams carrying out multimodal pathways to hasten recovery after a major operation. ERAS components generally include preoperative counseling and medical optimization, venous thromboembolism prophylaxis, ileus prevention, avoidance of fluid overload, normothermia maintenance, early mobilization, pain control and early feeding, all leading to early discharge without increased complications or readmissions. Although there may not be specific data pertaining to other major urologic operations, the principles remain similar and ERAS is easily applicable. Conclusion: The benefits of ERAS programs are well established for RC and principles are easily applicable to other major urology operations. Barriers to implantation and maintenance of ERAS must be recognized to continue to maintain the benefits of these programs.

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“…Marked differences exist between clinicians worldwide . Recent guidelines from the American Society of Colon and Rectal Surgeons strongly recommend the use of MOAB in elective colorectal resection to reduce SSI . Other international bodies have recognized the increasing body of evidence and altered their recommendations in a more conservative manner but stopped short of endorsing this practice because of the lack of Level 1 evidence .…”

Section: Introductionmentioning

confidence: 99%

The use of oral antibiotics and mechanical bowel preparation in elective colorectal resection for the reduction of surgical site infection

et al. 2020

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The American Society of Colon and Rectal Surgeons Clinical Practice Guidelines for the Use of Bowel Preparation in Elective Colon and Rectal Surgery

Cited by 131 publications

References 36 publications

Preoperative Bowel Preparation in Minimally Invasive and Vaginal Gynecologic Surgery

Preoperative Bowel Preparation in Minimally Invasive and Vaginal Gynecologic Surgery

Enhanced recovery after surgery review and urology applications in 2020

The use of oral antibiotics and mechanical bowel preparation in elective colorectal resection for the reduction of surgical site infection

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