Document Detail


Mechanical bowel preparation in intestinal surgery: a meta-analysis and review of the literature.
MedLine Citation:
PMID:  18622653     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: Despite several meta-analyses and randomized controlled trials showing no benefit to patients, mechanical bowel preparation (MBP) remains the standard of practice for patients undergoing elective colorectal surgery. METHODS: We performed a systematic review of the literature of trials that prospectively compared MBP with no MBP for patients undergoing elective colorectal resection. We searched MEDLINE, LILACS, and SCISEARCH, abstracts of pertinent scientific meetings and reference lists for each article found. Experts in the field were queried as to knowledge of additional reports. Outcomes abstracted were anastomotic leaks and wound infections. Meta-analysis was performed using Peto Odds ratio. RESULTS: Of 4,601 patients (13 trials), 2,304 received MBP (Group 1) and 2,297 did not (Group 2). Anastomotic leaks occurred in 97(4.2%) patients in Group 1 and in 81(3.5%) patients in Group 2 (Peto OR = 1.214, CI 95%:0.899-1.64, P = 0.206). Wound infections occurred in 227(9.9%) patients in Group 1 and in 201(8.8%) patients in Group 2 (Peto OR = 1.156, CI 95%:0.946-1.413, P = 0.155). DISCUSSION: This meta-analysis demonstrates that MBP provides no benefit to patients undergoing elective colorectal surgery, thus, supporting elimination of routine MBP in elective colorectal surgery. CONCLUSION: In conclusion, MBP is of no benefit to patients undergoing elective colorectal resection and need not be recommended to meet "standard of care."
Authors:
Carlos E Pineda; Andrew A Shelton; Tina Hernandez-Boussard; John M Morton; Mark L Welton
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Publication Detail:
Type:  Journal Article; Meta-Analysis; Review     Date:  2008-07-12
Journal Detail:
Title:  Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract     Volume:  12     ISSN:  1873-4626     ISO Abbreviation:  J. Gastrointest. Surg.     Publication Date:  2008 Nov 
Date Detail:
Created Date:  2008-10-22     Completed Date:  2009-02-11     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9706084     Medline TA:  J Gastrointest Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2037-44     Citation Subset:  IM    
Affiliation:
Department of Surgery, Stanford University School of Medicine, 300 Pasteur Drive, H3680, Stanford, CA 94305-5655, USA. cepineda@stanford.edu
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MeSH Terms
Descriptor/Qualifier:
Abdominal Cavity / microbiology
Anastomosis, Surgical / methods
Colectomy / methods*
Colorectal Neoplasms / diagnosis,  surgery*
Colorectal Surgery / methods
Female
Humans
Intestinal Mucosa / microbiology,  pathology
Irrigation / instrumentation,  methods*
Male
Preoperative Care / methods
Randomized Controlled Trials as Topic
Risk Factors
Sensitivity and Specificity
Surgical Procedures, Elective / methods*
Surgical Wound Infection / prevention & control*
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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