title: Comparison of oral polyethylene glycol plus a large volume glycerine enema with a large volume glycerine enema alone in patients undergoing colorectal surgery for malignancy: a randomized clinical trial.
abstract: OBJECTIVE
  Recent meta-analyses and randomized clinical trials have concluded that mechanical bowel preparation (MBP) before elective colorectal surgery is not associated with a reduction of surgical site infection (SSI). The aim of this randomized clinical trial was to evaluate the impact of preoperative MBP for colon and rectal cancer surgery in comparison with a single glycerine enema.
  
  
  METHODS
  Patients scheduled for radical colorectal resection for malignancy with primary anastomosis were randomized to preoperative MBP (4 l of polyethylene glycol) (group 1, 114 patients) plus a glycerine 5% enema (2 l) or a single glycerine 5% enema (2 l) (group 2, 115 patients). The postoperative incidence of SSI was recorded prospectively. Patients undergoing minimally invasive surgery (laparoscopy or robotic) accounted for 55 and 51 in groups 1 and 2 respectively.
  
  
  RESULTS
  In all, 229 patients were included in the study, 114 in group 1 and 115 in group 2. At least one SSI was reported in 16 (14.0%) group 1 and in 20 (17.8%) group 2 patients (P=0.475). Perioperative mortality was nil. The incidence of SSI was comparable also in the 73 patients who had a low anterior resection (seven of 33 vs eight of 40, P=1.000), and for the 106 patients who underwent a minimally invasive procedure (nine of 55 vs four of 51, P=0.241).
  
  
  CONCLUSIONS
  A single large-volume glycerine enema is effective bowel preparation before colorectal resection whether performed by an open or minimally invasive technique.
authors.affiliation: Division of General and Laparoscopic Surgery, European Institute of Oncology, Milan, Italy. emilio.bertani@ieo.it
authors.forename: E
authors.initials: E
authors.lastname: Bertani
authors.forename: A
authors.initials: A
authors.lastname: Chiappa
authors.forename: R
authors.initials: R
authors.lastname: Biffi
authors.forename: P P
authors.initials: PP
authors.lastname: Bianchi
authors.forename: D
authors.initials: D
authors.lastname: Radice
authors.forename: V
authors.initials: V
authors.lastname: Branchi
authors.forename: S
authors.initials: S
authors.lastname: Spampatti
authors.forename: I
authors.initials: I
authors.lastname: Vetrano
authors.forename: B
authors.initials: B
authors.lastname: Andreoni
mesh_terms: D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002400:Cathartics / Q000008:administration & dosage*; D015179:Colorectal Neoplasms / Q000601:surgery*; D004733:Enema; D005260:Female; D005990:Glycerol / Q000008:administration & dosage*; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D011092:Polyethylene Glycols / Q000008:administration & dosage*; D011183:Postoperative Complications; D011300:Preoperative Care; D012371:Robotics; D013530:Surgical Wound Infection
chemical_list: D002400:Cathartics; D011092:Polyethylene Glycols; D005990:Glycerol