Colon and rectal surgery for cancer without mechanical bowelpreparation: one-center randomizedprospective trial: OP04

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Aim:Mechanical bowelpreparation is routinely done before colon and rectal surgery, aimed at reducing the risk of postoperative infectious complications. In this study, we assessed whether elective colon and rectal surgery can be safely performed withoutpreoperative mechanical bowelpreparation.Method:Patients undergoing elective colon and rectal resections withprimary anastomoses wereprospectively randomized into two groups. Group A had mechanical bowelpreparation with polyethylene glycol before surgery and group B had their surgery withoutpre-operative mechanical bowelpreparation. Patients were followed up for 30 days to study wound and intra-abdominal infectious together with anastomotic complications.Results:Two hundred and forty four patients were included in the study; 120 in group A and 124 in group B. Demographic characteristics, type of surgicalprocedure and type of anastomosis did not significantly differ between the two groups. There was no difference in the rate of surgical infectious complications between the two groups but the overall infectious complications rate was 20.0% in group A and 11.3% in group B (P = 0.05). Wound infection, anastomotic leak, and intra-abdominal abscess occurred in 9.2%, 5.8%, and 5.0% vs 4.8%, 4.0%, and 2.4%, respectively.Conclusion:No mechanical bowelpreparation seems to be safe both in colonic and also in rectal surgery. These results suggest that elective colon and rectal surgery may be safely performed without mechanicalpreparation.

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