Mechanical bowel preparation or not for elective colorectal surgery.
BACKGROUND
Mechanical bowel preparation has been a mainstay in the management of patients undergoing elective colorectal surgery, but in recent years, this practice has been challenged; and a number of clinical reports have demonstrated no benefit, as judged by reduction of surgical site infections. This paper presents the advantages and disadvantages of mechanical bowel preparation.


METHODS
Review of the pertinent English language literature.


RESULTS
Some published studies support omission of mechanical preparation of the colon prior to elective colo-rectal surgery. However, the evidence is not definitive, in that the most rigorous study performed to date, a large, randomized trial, is non-confirmatory.


CONCLUSIONS
Additional stratified studies of different mechanical bowel preparation methods, compared with no preparation, are required to address whether the practice should be abandoned.
Itani
Kamal M F
KM
Veterans Affairs Boston Health Care System and Boston University School of Medicine, Boston, Massachusetts, USA. kitani@med.va.gov
Kim
Lawrence
L
D002400:Cathartics / Q000592:standards / Q000627:therapeutic use*; D003107:Colorectal Surgery / Q000592:standards*; D013505:Digestive System Surgical Procedures / Q000592:standards*; D017558:Elective Surgical Procedures / Q000592:standards; D006801:Humans; D015201:Meta-Analysis as Topic; D017410:Practice Guidelines as Topic; D011300:Preoperative Care / Q000592:standards*; D016032:Randomized Controlled Trials as Topic; D013530:Surgical Wound Infection / Q000517:prevention & control
D002400:Cathartics