Is mechanical bowel preparation really necessary in colorectal surgery?
OBJECTIVE
To determine the outcome of colorectal surgery without mechanical bowel preparation.


METHODS
A descriptive, analytical and observational study.


METHODS
Combined Military Hospital, Kharian and Pano Aqil, from September 1998 to April 2003.


METHODS
Forty-seven patients underwent debridement/resection and repair/primary anastomosis of colon and upper rectum without bowel preparation. Of these, 16 patients were operated in emergency. The anastomosis was carried out with polyglactin (vicryl) interrupted, full thickness single layer and no patient had defunctioning colostomy. Third generation cephalosporin, cefotaxime or ceftazidime and metronidazole were given perioperatively, repeated during surgery if lasted for more than 2 hours and continued for 3-5 days postoperatively.


RESULTS
Anastomoses were ileocolic in 29.7%, colicocolic in 61.7% and colorectal in 14.8% cases. Anastomotic failure was seen in 4.2% and wound infection in 8.5% cases. There was one mortality (2.1%) due to unrelated cause.


CONCLUSIONS
Mechanical bowel preparation is not necessary for safe colorectal surgery.
Ahmad
Maqbool
M
Department of Surgery, Combined Military Hospital, Pano Aqil Cantt. maqbool957@yahoo.com
Abbas
Safdar
S
Asghar
Muhammad Imran
MI
D000293:Adolescent; D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical; D019072:Antibiotic Prophylaxis; D002400:Cathartics / Q000008:administration & dosage; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003108:Colonic Diseases / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D003107:Colorectal Surgery / Q000379:methods* / Q000401:mortality; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011300:Preoperative Care / Q000379:methods*; D012002:Rectal Diseases / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D012189:Retrospective Studies; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D016019:Survival Analysis; D007507:Therapeutic Irrigation; D016896:Treatment Outcome; D019564:Unnecessary Procedures
D002400:Cathartics