Seminars in Colon & Rectal Surgery
Volume 21, Issue 3 , Pages 144-147 , September 2010

Bowel Preparation Before Elective Colorectal Surgery: What is the Evidence

  • C. Neal Ellis, MD

      Affiliations

    • Corresponding Author InformationAddress reprint requests to C. Neal Ellis, MD, FACS, FASCRS, FACG, Division of Colon & Rectal Surgery, 320 East North Avenue, Suite 559, Pittsburgh, PA 15212

References 

  1. Mangram AJ, Horan TC, Pearson ML, et al. Guideline for prevention of surgical site infection, 1999 (Hospital Infection Control Practices Advisory Committee). Infect Control Hosp Epidemiol. 1999;20:250–278
  2. Gaynes RP, Culver DH, Horan TC, et al. Surgical site infection (SSI) rates in the United States, 1992-98: The National Nosocomial Infections Surveillance System basic SSI risk index. Clin Infect Dis. 2001;33(suppl 2):S69–S77
  3. Astagneau P, Rioux C, Golliot F, et al. Morbidity and mortality associated with surgical site infections: Results from the 1997-1999 INCISO surveillance. J Hosp Infect. 2001;48:267–274
  4. Nichols RL, Choe EU, Weldon CB. Mechanical and antibacterial preparation in colon and rectal surgery. Chemotherapy. 2005;51(suppl 1):115–121
  5. Buchs NC, Gervaz P, Secic M, et al. Incidence, consequences, and risk factors for anastomotic dehiscence after colorectal surgery: A prospective monocentric study. Int J Colorectal Dis. 2008;23:265–270
  6. Yeh CY, Changchien CR, Wang JY, et al. Pelvic drainage and other risk factors for leakage after elective anterior resection in rectal cancer patients: A prospective study of 978 patients. Ann Surg. 2005;241:9–13
  7. Rullier E, Laurent C, Garrelon JL, et al. Risk factors for anastomotic leakage after resection of rectal cancer. Br J Surg. 1998;85:355–358
  8. Irvin TT, Golligher JC. Aetiology of disruption of intestinal anastomosis. Br J Surg. 1973;60:461–464
  9. Halsted WS. Circular suture of the intestine: An experimental study. Am J Med Sci. 1887;94:436–461
  10. Chung RS, Gurl NJ, Berglund EM. A controlled trial of whole gut lavage as a method of bowel preparation for colonic operations. Am J Surg. 1979;137:75–81
  11. Clarke JS, Condon RE, Bartlett JG, et al. Preoperative oral antibiotics reduce septic complications of colon operations: Results of a prospective, randomized, double blind clinical study. Ann Surg. 1977;186:251–259
  12. Nichols RL, Condon RE. Preoperative preparation of the colon. Surg Gynecol Obstet. 1971;2:323–337
  13. Zmora O, Wexner SD, Hajjar L, et al. Trends in preparation for colorectal surgery: Survey of the members of the American Society of Colon and Rectal Surgeons. Am Surg. 2003;69:150–154
  14. Dorudi S, Wilson NM, Heddle RM, et al. Primary restorative colectomy in malignant left sided large bowel obstruction. Ann R Coll Surg Edin. 1990;72:393–395
  15. Duthie GS, Foster ME, Price-Thomas JM, et al. Bowel preparation or not for elective colorectal surgery. Ann R Coll Surg Edin. 1990;35:169–171
  16. Grabham JA, Moran BJ, Lane RHS. Defunctioning colostomy for low anterior resection: A selective approach. Br J Surg. 1995;82:1331–1332
  17. Mealy K, Burke P, Hyland J. Anterior resection without a defunctioning colostomy: Questions of safety. Br J Surg. 1992;79:305–307
  18. de Graaf P, Slagt C, de Graaf JL, et al. Fatal aspiration of polyethylene glycol solution. Neth J Med. 2006;64:196–198
  19. Oliveira L, Wexner SD, Daniel N, et al. Mechanical bowel preparation for elective colorectal surgery (A prospective, randomized, surgeonblinded trial comparing sodium phosphate and polyethylene glycol-based oral lavage solutions). Dis Colon Rectum. 1997;40:585–591
  20. Mathus-Vliegen EM, Kemble UM. A prospective randomized blinded comparison of sodium phosphate and polyethylene glycol-electrolyte solution for safe bowel cleansing. Aliment Pharmacol Ther. 2006;23:543–552
  21. Gonlusen G, Akgun H, Ertan A, et al. Renal failure and nephrocalcinosis associated with oral sodium phosphate bowel cleansing: Clinical patterns and renal biopsy findings. Arch Pathol Lab Med. 2006;130:101–106
  22. Ullah N, Yeh R, Ehrinpreis M. Fatal hyperphosphatemia from a phosphosoda bowel preparation. J Clin Gastroenterol. 2002;34:457–458
  23. Markowitz GS, Stokes MB, Radhakrishnan J, et al. Acute phosphate nephropathy following oral sodium phosphate bowel purgative: An underrecognized cause of chronic renal failure. J Am Soc Nephrol. 2005;16:3389–3396
  24. Muzii L, Bellati F, Zullo MA, et al. Mechanical bowel preparation before gynecologic laparoscopy: A randomized single blind, controlled trial. Fertil Steril. 2006;85:689–693
  25. Mahajna A, Krausz M, Rosin D, et al. Bowel preparation is associated with spillage of bowel contents in colorectal surgery. Dis Colon Rectum. 2005;48:1626–1631
  26. Bucher P, Gervaz P, Egger JF, et al. Morphologic alteratuions associated with mechanical bowel preparation before elective colorectal surgery: A randomized trial. Dis Colon Rectum. 2006;49:109–112
  27. Nichols RL, Gorbach SL, Condon RE. Alteration of intestinal microflora following preoperative mechanical preparation of the colon. Dis Colon Rectum. 1971;14:123–127
  28. Smith MB, Batiga P, Sartor WM, et al. Intraoperative colonic lavage: Failure to decrease mucosal microflora. South Med J. 1991;84:38–42
  29. Bleday R, Braidt J, Ruoff K, et al. Quantitative cultures of the mucosal associated bacteria in the mechanically prepared colon and rectum. Dis Colon Rectum. 1993;36:844–849
  30. Nichols RL, Condon RE, Gorbacj SL, et al. Effect of preoperative antimicrobial preparation of the bowel. Ann Surg. 1972;176:227–232
  31. Matheson DM, Arabi Y, Baxter-Smith D, et al. Randomized multicentre trial of oral bowel preparation and antimicrobials for elective colorectal operations. Br J Surg. 1978;65:597–600
  32. McCahill LE, Ahern JW, Gruppi LA, et al. Enhancing compliance wit Medicare guidelines for surgical infection prevention: Experience with a cross-disciplinary quality improvement team. Arch Surg. 2007;142:355–361
  33. Bucher P, Gervaz P, Soravia C, et al. Randomized clinical trial of mechanical bowel preparation versus no preparation before elective left-sided colorectal surgery. Br J Surg. 2005;92:409–414
  34. Burke P, Mealy K, Gillen P, et al. Requirement for bowel preparation in colorectal surgery. Br J Surg. 1994;81:907–910
  35. Contant CME, Hop WCJ, Van't Sant HP, et al. Mechanical bowel preparation for elective colorectal surgery: A multicentre randomised trial. Lancet. 2007;370:2112–2117
  36. Fa-Si-Oen P, Roumen R, Buitenweg JA, et al. Mechanical bowel preparation or not? (Outcome of a multicenter, randomized trial in elective open colon surgery). Dis Colon Rectum. 2005;48:1509–1516
  37. Jung B, Pahlman L, Nyström PO, et al. For the Mechanical Bowel Preparation Study Group (Multicentre randomized clinical trial of mechanical bowel preparation in elective colonic surgery). Br J Surg. 2007;94:689–695
  38. Miettinen RPJ, Laitinen ST, Makela JT, et al. Bowel preparation with oral polyethylene glycol electrolyte solution vs. no preparation in elective open colorectal surgery. Dis Colon Rectum. 2000;43:669–677
  39. Pena-Soria MJ, Mayol JM, Anula-Fernandez R, et al. Mechanical bowel preparation for elective colorectal surgery with primary intraperitoneal anastomosis by a single surgeon: Interim analysis of a prospective single-blinded randomized trial. J Gastrointest Surg. 2007;11:562–567
  40. Ram E, Sherman Y, Weil R, et al. Is mechanical bowel preparation mandatory for elective colon surgery. Arch Surg. 2005;140:285–288
  41. Santos JCM, Batista J, Sirimarco MT, et al. Prospective randomized trial of mechanical bowel preparation in patients undergoing elective colorectal surgery. Br J Surg. 1994;81:1673–1676
  42. Zmora O, Mahajna A, Bar-Zakai B, et al. Colon and rectal surgery without mechanical bowel preparation (A randomized prospective trial). Ann Surg. 2003;237:363–367
  43. van't Sant HP, Weidema WF, Hop WCJ, et al. The influence of mechanical bowel preparation in elective lower colorectal surgery. Ann Surg. 2010;251:59–63
  44. Guenaga KKFG, Matos D, Wille-Jorgensen P: Mechanical bowel preparation for elective colorectal surgery (review). Cochrane Library, Issue 1, 2009
  45. Zhu QD, Zhang QY, Zeng QQ, et al. Efficacy of mechanical bowel preparation with poluethylene glycol in prevention of postoperative complications in elective colorectal surgery: A meta-analysis. Int J Colorectal Dis. 2010;25:267–275
  46. Gravante G, Caruso R, Andreani SM, et al. Mechanical bowel preparation for colorectal surgery: A meta-analysis on abdominal and systemic complications on almost five thousand patients. Int J Colorectal Dis. 2008;23:1145–1150
  47. Pineda CE, Shelton AA, Hernandez T, et al. Mechanical bowel preparation in intestinal surgery: A meta-analysis and review of the literature. J Gastrointest Surg. 2008;12:2037–2044

PII: S1043-1489(10)00042-4

doi: 10.1053/j.scrs.2010.05.004

Seminars in Colon & Rectal Surgery
Volume 21, Issue 3 , Pages 144-147 , September 2010