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 May;11(5):562-7. doi: 10.1007/s11605-007-0139-6.

Abstract

We report an interim analysis of a prospective single-blinded randomized trial designed to investigate whether preoperative mechanical bowel preparation influences the rate of surgical-site infection and anastomotic failure after elective colorectal surgery with primary intraperitoneal anastomosis performed by a single surgeon. Patients scheduled to undergo an elective colorectal procedure with a primary intraperitoneal anastomosis were randomized to receive either oral polyethylene glycol lavage solution and enemas (group A) or no preparation (group B). Surgical-site infection and anastomotic failure were investigated. Of 97 patients included, 48 were assigned to group A and 49 to group B. Twelve (12.4%) developed wound infections, six in each group (12.5 vs. 12.2%; NS). Intra-abdominal sepsis was only seen in group A (n = 3, 6.3%). Anastomotic failure occurred in four patients in group A (8.3%) vs. two patients in group B (4.1%) (NS). The overall complication rate in group A was 27.1%, vs. 16.3% in group B. The number needed to harm was 9.3. Our interim analysis of a prospective single-blinded randomized trial suggests that a surgeon may have the same or even worse outcomes when mechanical bowel preparation is routinely used for colorectal surgery with primary intraperitoneal anastomosis.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Abdomen
  • Aged
  • Aged, 80 and over
  • Anastomosis, Surgical / adverse effects
  • Anastomosis, Surgical / methods*
  • Cathartics* / administration & dosage
  • Colonic Diseases / surgery*
  • Cutaneous Fistula / etiology
  • Elective Surgical Procedures
  • Enema*
  • Feces
  • Female
  • Follow-Up Studies
  • Humans
  • Intestinal Fistula / etiology
  • Male
  • Polyethylene Glycols / administration & dosage
  • Preoperative Care*
  • Prospective Studies
  • Rectal Diseases / surgery*
  • Sepsis / etiology
  • Single-Blind Method
  • Surgical Wound Dehiscence / etiology
  • Surgical Wound Infection / etiology
  • Therapeutic Irrigation

Substances

  • Cathartics
  • Polyethylene Glycols