Bowel preparation with oral polyethylene glycol electrolyte solution vs. no preparation in elective open colorectal surgery - Prospective, randomisedstudy

PURPOSE: Efficient mechanical bowel preparation has been regarded as essent ial in preventing postoperative complications of colorectal surgery, but th e necessity of bowel cleansing has been disputed recently. The aim of this study was to evaluate the outcome of elective colorectal surgery in patient s with or without bowel preparation. METHODS: Altogether, 267 consecutive a dult patients admitted for elective open colorectal surgery were randomly a ssigned either to the bowel preparation group with oral polyethylene glycol electrolyte solution (138 patients) or no preparation group (129 patients) . Patients who were unable to drink polyethylene glycol electrolyte solutio n, those who had had bowel preparation within the previous week, and patien ts not needing opening of the bowel were excluded. Routine colorectal surge ry was undertaken, and infectious and other complications were registered d aily. Late complications were checked up one to two months after surgery. R ESULTS: No deaths were recorded, and 76 percent of the patients in the poly ethylene glycol electrolyte solution group and 81 percent in the unprepared group recovered without complication. Anastomotic leaks occurred in 4 perc ent of the polyethylene glycol electrolyte solution patients and in 2 perce nt of the other cases, and other surgical site infections occurred in 6 and 5 percent, respectively. None of the differences was statistically signifi cant. There was no difference in restoration of bowel function. The median postoperative stay was eight days in both groups. CONCLUSIONS: Preoperative bowel preparation seems to offer no benefit in elective open colorectal su rgery.