Is mechanical bowel preparation really necessary in colorectal surgery?

ABSTRACT

To determine the outcome of colorectal surgery without mechanical bowel preparation. Design: A descriptive, analytical and observational study. Place and Duration of Study Combined Military Hospital, Kharian and Pano Aqil, from September 1998 to April 2003. Subjects and Forty-seven patients underwent debridement/resection and repair/ primary anastomosis of colon and upper rectum without bowel preparation. Of these,16 patients were operated in emergency. The anastomosis was carried out with polyglactin [vicryl] interrupted, full thickness single layer and no patient had defunctioning colostomy. Third generation cephalosporin, cefotaxime or ceftazidime and metronidazole were given perioperatively, repeated during surgery if lasted for more than 2 hours and continued for 3-5 days postoperatively. Anastomoses were ileocolic in 29.7%, colicocolic in 61.7% and colorectal in 14.8% cases. Anastomotic failure was seen in 4.2% and wound infection in 8.5% cases. There was one mortality [2.1%] due to unrelated cause. Mechanical bowel preparation is not necessary for safe colorectal surgery