title: Does using comprehensive preoperative bowel preparation offer any advantage for urinary diversion using ileum? A meta-analysis.
abstract: OBJECTIVE
  The aim of this study was to compare the efficacy of comprehensive bowel preparation to that of limited bowel preparation in prevention of postoperative complications in elective urinary diversion surgery by using ileum.
  
  
  METHODS
  Literature search of PubMed, EMBASE and the Cochrane Library was done to identify randomized controlled trials (RCTs) and cohort studies involving comparison of postoperative complications after comprehensive bowel preparation and limited bowel preparation. A meta-analysis was carried out to distinguish overall differences between the two groups.
  
  
  RESULTS
  Our literature search yielded two randomized controlled trials and two cohort studies, involving a total of 346 patients, which met our inclusion criteria. There was no significant difference between the comprehensive bowel preparation and limited bowel preparation in wound infection [relative risk (RR) 95 % confidence interval (CI), 1.05(0.46-2.40); P = 0.86], mortality [RR 95 % CI, 1.06 (0.32-3.55); P = 0.76], ileus [RR 95 % CI, 0.86 (0.37, 2.00); P = 0.40], sepsis [RR 95 % CI, 0.71 (0.20, 2.52); P = 0.78], anastomotic leakage [RR 95 % CI, 0.81 (0.15, 4.21); P = 0.83], wound dehiscence [RR 95 % CI, 0.92 (0.40, 2.13); P = 0.67], peritonitis [RR 95 % CI, 0.64 (0.08, 5.10); P = 0.63] or fistula [RR 95 % CI, 0.71 (0.18,2.75); P = 0.63].
  
  
  CONCLUSIONS
  The limited evidence available demonstrated that the use of comprehensive bowel preparation for urinary diversion surgery using ileum does not offer any significant advantage over limited bowel preparation. Future work should target more high-quality RCTs to confirm this.
authors.affiliation: Department of Urology, West China Hospital, Sichuan University, 37# Guoxuexiang Street, Chengdu 610041, China.
authors.forename: Luo
authors.initials: L
authors.lastname: Yang
authors.forename: Heng-shan
authors.initials: HS
authors.lastname: Chen
authors.forename: Blayne
authors.initials: B
authors.lastname: Welk
authors.forename: John D
authors.initials: JD
authors.lastname: Denstedt
authors.forename: Kunjie
authors.initials: K
authors.lastname: Wang
authors.forename: Hong
authors.initials: H
authors.lastname: Li
authors.forename: Qiang
authors.initials: Q
authors.lastname: Wei
authors.forename: Xiang
authors.initials: X
authors.lastname: Li
mesh_terms: D002400:Cathartics / Q000008:administration & dosage*; D016001:Confidence Intervals; D006801:Humans; D007082:Ileum / Q000601:surgery; D011183:Postoperative Complications / Q000209:etiology*; D014547:Urinary Diversion / Q000009:adverse effects* / Q000379:methods*
chemical_list: D002400:Cathartics