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Clin Colon Rectal Surg 2009; 22(1): 014-020
DOI: 10.1055/s-0029-1202881
© Thieme Medical Publishers

Bowel Preparation: Current Status

James E. Duncan1 , Christie M. Quietmeyer1
  • 1Department of Surgery, National Naval Medical Center (NNMC), Bethesda, Maryland
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Publikationsdatum:
09. März 2009 (online)

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ABSTRACT

Despite emerging evidence from randomized controlled trials and meta-analyses questioning its use, mechanical bowel preparation (MBP) continues to hold an accepted place among surgeons. MBP has been administered to patients for over a century, and though the methods and agents used for intestinal cleansing have evolved over time, many surgeons still embrace MBP as a necessary, essential regimen. The accepted rationale for MBP includes evacuation of stool to allow visualization of the luminal surfaces as well as to reduce the fecal flora, which is believed to translate into lower risk of infectious and anastomotic complications at surgery. The authors describe the history of MBP as it relates to colorectal surgery and review the agents currently used for mechanical bowel preparation. Additionally, they summarize the recent trials, meta-analyses, and other emerging data from the medical literature that suggest MBP offers no benefit as a preoperative measure and question its place in current surgical practice.

KEYWORDS

Mechanical bowel preparation - colorectal surgery - polyethylene glycol - sodium phosphate

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James E DuncanM.D. 

Department of Surgery, National Naval Medical Center (NNMC)

8901 Wisconsin Ave., Bethesda, MD 20889

eMail: james.duncan@med.navy.mil