[Feasibility of colorectal surgery without colonic preparation. A prospective study].
BACKGROUND
Mechanical bowel preparation (MBP), aimed at reducing the infectious complications of colorectal surgery, was considered as indispensable. This benefit is actually disputed. The aim of this study was to report an experience of colorectal surgery without MBP.


METHODS
Hundred ninety patients without MBP and without low residue diet, who underwent colorectal surgery with primary anastomosis not requiring a diverting stoma were included. The main outcome were the rate of mortality, anastomotic leak, wound infection and intra-abdominal abscess. Secondary outcomes were duration of intravenous perfusion, nasogastric aspiration, total hospitalisation stay and time to realimentation.


RESULTS
The procedure was performed by laparotomy (n=142) or laparoscopy (n=48). Forty-eight patients underwent emergency surgery. Ninety-two patients were operated for malignancy. The rate of mortality was 6.3% in correlation with the scale of AFC. The rate of anastomotic leak was 3.7%. The rate of specific morbidity was independent of scale of AFC on the contrary to the frequency of non-specific complications. The mean duration of intravenous perfusion and nasogastric suction were 6 days and 0.3 day. The patient had normal diet to the 4th day (4+/-3 days). The mean hospital stay was 13.4 days.


CONCLUSIONS
The colorectal surgery without MBP may be safely performed and could improve the quality of life of patients in the perioperatory period.
Pirró
N
N
Service de chirurgie digestive, hôpital Sainte-Marguerite, 270, boulevard de Sainte-Marguerite, 13274 Marseille cedex 09, France. nicolas.pirro@ap-hm.fr
Ouaissi
M
M
Sielezneff
I
I
Fakhro
A
A
Pieyre
A
A
Consentino
B
B
Sastre
B
B
D000367:Age Factors; D000368:Aged; D003082:Colectomy; D003106:Colon / Q000601:surgery*; D003113:Colonoscopy; D003627:Data Interpretation, Statistical; D013505:Digestive System Surgical Procedures / Q000401:mortality; D004630:Emergencies; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D010535:Laparoscopy; D007813:Laparotomy; D007902:Length of Stay; D008297:Male; D011183:Postoperative Complications / Q000517:prevention & control; D011184:Postoperative Period; D011300:Preoperative Care / Q000379:methods*; D011446:Prospective Studies; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic; D012007:Rectum / Q000601:surgery*; D012307:Risk Factors; D013997:Time Factors