Mechanical bowel preparation for elective colorectal surgery with primary intraperitoneal anastomosis by a single surgeon: interim analysis of a prospective single-blinded randomized trial.
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.
Pena-Soria
Maria Jesús
MJ
Servicio de Cirugía I, Division of Colorectal Surgery, Hospital Clínico San Carlos, Universidad Complutense de Madrid Medical School, Madrid 28040, Spain.
Mayol
Julio M
JM
Anula-Fernandez
Rocio
R
Arbeo-Escolar
Ana
A
Fernandez-Represa
Jesús A
JA
D000005:Abdomen; D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical / Q000009:adverse effects / Q000379:methods*; D002400:Cathartics / Q000008:administration & dosage; D003108:Colonic Diseases / Q000601:surgery*; D017577:Cutaneous Fistula / Q000209:etiology; D017558:Elective Surgical Procedures; D004733:Enema; D005243:Feces; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007412:Intestinal Fistula / Q000209:etiology; D008297:Male; D011092:Polyethylene Glycols / Q000008:administration & dosage; D011300:Preoperative Care; D011446:Prospective Studies; D012002:Rectal Diseases / Q000601:surgery*; D018805:Sepsis / Q000209:etiology; D016037:Single-Blind Method; D013529:Surgical Wound Dehiscence / Q000209:etiology; D013530:Surgical Wound Infection / Q000209:etiology; D007507:Therapeutic Irrigation
D002400:Cathartics; D011092:Polyethylene Glycols