Comparison Between Mechanical and Non Mechanical Bowel Preparation Prior To Elective Colorectal Surgery

Abstract

Background: Bowel preparation prior to
colonic surgery usually includes antibiotic
therapy together with mechanical bowel
preparation which may cause discomfort to the
patients, prolonged hospitalization and water
& electrolyte imbalance.
Objective: to assess whether elective colon
and rectal surgery may be safely performed
without preoperative mechanical bowel
preparation.
Method: the study includes all patients who
had elective large bowel resection at Medical
City – Baghdad Teaching Hospital between
Feb, 2007 to Jan, 2010. Emergency operations
were not included. The patients were randomly
assigned to the 2 study groups (with or without
mechanical bowel preparation.
Results: A total of 165 patients participated
in the study, 82 with mechanical bowel
preparation and 83 without. The 2 groups
were similar in age, sex and type of surgical
procedure. 134 patients (81.2 %) underwent
surgery owing to colorectal cancer & 31
patients (18.8 %) owing to benign disease.
The hospitalization period was longer in the
bowel-prepared group (mean ± SD, 8.2 ± 5.1
days) as compared with the non prepared
group (mean ± SD, 8.0 ± 2.7 days). However,
this difference was not statistically significant.
The time until the 1st bowel movement was
similar between the 2 groups : a mean ± SD of
4.2 ± 1.3 days in the non prepared group as
compared with a men ± SD 4.3 ± 1.1 days in
the prepared group ( P = NS ).
Conclusion: Our results suggest that no
advantage is gained by preoperative
mechanical bowel preparation in elective
colorectal surgery.