Are enemas given before abdominal operations useful? A prospective randomised trail

[Preoperative bowel preparation--is it useful?]

Mechanical cleansing of the colon prior to elective colorectal surgery is a dogmatically established belief in surgery. Polyethylene glycol was extensively used in the 1980's and 1990's but has been largely replaced by other laxative solutions such as sodium phosphate which are better tolerated by the patient. Evidence-based data in the surgical literature question the dogma of routine mechanical bowel cleansing (8 randomized controlled studies and 4 meta-analyses). These data show with a good level of evidence that mechanical bowel preparation is unnecessary and perhaps harmful.

Preoperative mechanical bowel preparation unnecessary in patients undergoing thoracic surgery

OBJECTIVE

The purpose of this study was to assess a hypothesis that routine mechanical bowel preparation (MBP) is unnecessary before thoracic surgery.

METHODS

Five hundreds and sixty cases of standard thoracic surgery including unilateral thoracotomies, bilateral thoracotomies, median sternotomies and video-assisted thoracic surgery have been performed in Kyushu Medical Center Hospital from June 1999 to December 2002. Two hundreds and eighty cases received preoperative MBP and the other 280 cases did not receive it. The usefulness of MBP was assessed retrospectively with these patients.

RESULTS

It proved that cessation of MBP did not provide any disadvantage for postoperative complication and hospital stay.

CONCLUSIONS

From these results, routine MBP appears to be unnecessary before thoracic surgery.