Bowel preparation vs no bowel preparation for elective colectomy


  • Dawn O'Shea
  • Univadis Medical News
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Mechanical and oral antibiotic bowel preparation (MOABP) does not reduce surgical site infections (SSIs) or overall morbidity associated with colon surgery, according to a new study published in The Lancet.

In the multicentre, parallel, single-blinded trial, patients undergoing colon resection were randomly assigned (1:1) to either MOABP or no bowel preparation (NBP) in four hospitals in Finland.

Key exclusion criteria included need for emergency surgery; bowel obstruction; colonoscopy planned during surgery; allergy to polyethylene glycol, neomycin or metronidazole; and age younger than 18 years or older than 95 years.

MOABP consisted of 2 L of polyethylene glycol and 1 L of clear fluid before 6 pm on the day before surgery, 2 g of neomycin orally at 7 pm and 2 g of metronidazole orally at 11 pm.

SSI was detected in 13 (7%) of 196 patients randomised to MOABP and 21 (11%) of 200 patients randomised to NBP (odds ratio [OR] 1.65; 95% CI 0.80-3.40; P=.17). Anastomotic dehiscence was reported in 4 per cent in both groups, and reoperations were necessary in 8 per cent of patients in the MOABP and 7 per cent in the NBP group. Within 30 days, two patients died in the NBP group and none in the MOABP group.