Bowel Preparation Before Colorectal Surgery Doesn’t Prevent Anastomotic Leaks

Mechanical bowel preparation before colorectal surgery is thought to diminish postoperative anastomotic leakage by reducing fecal impaction at the suture line. Several recent studies have suggested, however, that bowel preparation might increase anastomotic leakage, perhaps because liquefied stool can spill more readily than solid stool.

Dutch researchers randomized 1354 patients who were scheduled for elective colorectal surgery to undergo mechanical bowel prep (with polyethylene glycol and bisacodyl or with sodium phosphate solution) or not. After a median 24 days of follow-up, the two groups had statistically similar rates for the primary endpoints of mortality and anastomotic leakage. Intra-abdominal abscesses associated with anastomotic…