The role of mechanical bowel preparation for colonic resection and anastomosis: an experimental study.
To evaluate the effect of mechanical bowel preparation (MBP) on colonic resection and anastomosis.



Mongrel dogs were divided into two groups of 20 animals each. During the preoperative period (24 h) group A was not subjected to MBP, and group B was fasted and ingested 20 ml magnesium hydroxide plus 15 ml/kg 10% mannitol orally. All animals underwent segmental colectomy followed by end-to-end anastomosis. The survivors of both groups were reoperated upon on the 7th postoperative day.



Mortality before reoperation was significantly higher in group A (45%) than in group B (10%; P<0.05). Upon reoperation on surviving animals the incidence of localized anastomotic leakage, leakage with peritonitis, and healed anastomoses was 72.72%, 9.09%, and 18.8% in group A, and 66.66%, 22.22%, and 11.11% in group B, respectively (P>0.05). Aerobic and anaerobic bacterial cultures showed similar growth in the two groups.



We conclude that the omission of MBP increased the mortality due to early anastomotic leakage with peritonitis; MBP did not change the rate of localized anastomotic leakage, leakage with peritonitis, or intact anastomoses on the 7th day; no quantitative or qualitative differences were observed in the bacteria isolated from the two groups.
Feres
O
O
Department of Surgery, Hospital and School of Medicine of Ribeirao Preto, University of São Paulo, Brazil.
Monteiro dos Santos
J C
JC
Andrade
J I
JI
D000284:Administration, Oral; D000714:Anastomosis, Surgical; D000818:Animals; D017609:Barium Compounds / Q000494:pharmacology; D003082:Colectomy / Q000379:methods*; D004285:Dogs; D004733:Enema / Q000379:methods; D005260:Female; D008276:Magnesium Hydroxide / Q000008:administration & dosage; D008353:Mannitol / Q000008:administration & dosage; D023421:Models, Animal; D011300:Preoperative Care / Q000379:methods*; D011336:Probability; D012680:Sensitivity and Specificity; D018709:Statistics, Nonparametric; D007507:Therapeutic Irrigation / Q000379:methods*
D017609:Barium Compounds; D008353:Mannitol; D008276:Magnesium Hydroxide