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The Safety of Elective Colorectal Surgery without Mechanical Bower Preparation

Article information

Kosin Med J. 2012;27(2):105-110
Publication date (electronic) : 2012 December 27
doi : https://doi.org/10.7180/kmj.2012.27.2.105
Chul-Min Lee, Seung-Hyun Lee, Byung-Kwon Ahn, Sung-Uhn Baek
Department of Surgery, College of Medicine, Kosin University, Busan, Korea.
Corresponding Author: Seung-Hyun Lee, Department of Surgery, College of Medicine, Kosin University, 34 Amnam-dong, Seo-gu, Busan, 602-702, Korea. TEL: +82-51-990-6231, FAX: +82-51-246-6093, gscrslsh@hanmail.net
Received 2012 March 12; Revised 2012 July 21; Accepted 2012 August 05.

Abstract

Objectives

To reduce the risk of postoperative infectious complications and anastomotic leakage in colorectal surgery, preoperative mechanical bowel preparation (MBP) is performed routinely. The aim of this study was to evaluate the safety of primary anastomosis in elective colorectal surgery without MBP.

Methods

From Jan. 2005 to Dec. 2006, three hundred and seventy-nine patients of elective colorectal surgery with primary anastomosis were performed with MBP in 352 cases (Prep group) and without MBP in 24 cases (Non-prep group). For preoperative MBP, 4 liters of polyethylene glycol solution was administered. Postoperative infectious complications and other morbidity were reviewed with medical records and prospectively collected data.

Results

Demographic, clinical and treatment characteristics did not differ significantly between the two groups. The overall rate of abdominal infectious complications (wound infection, anastomotic leak) was 2.9 % in the Prep group and 9 % in the Non-prep group (P > 0.05). Anastomotic leak occurred in nine patients (2.6%) in the Prep group and one (4.5%) in the Non-prep group.

Conclusions

The incidence of infectious complications after elective colorectal surgery without MBP did not differ significantly compare to that with MBP. However, prospective, randomized clinical trial is needed to assess the safety of primary anastomosis in elective colorectal surgery without MBP.

Keywords: Colorectal Surgery; Complication; Mechanical Bowel Preparation

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Table 1

Demographics of elective colorectal surgery

Table 1

*Values are mean (range); other values in parentheses are percentage; †Right-side colon, which included appendix, cecum, ascending colon, hepatic flexure, and transverse colon; ‡Left-side colon, which included splenic flexure, descending colon, and sigmoid colon.

Table 2

Postoperative complications of elective colorectal surgery

Table 2