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Mechanical bowel preparation or not for elective colorectal surgery.

Itani KM, Kim L. Mechanical bowel preparation or not for elective colorectal surgery. Surgical Infections. 2008 Dec 1; 9(6):563-5.

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BACKGROUND: Mechanical bowel preparation has been a mainstay in the management of patients undergoing elective colorectal surgery, but in recent years, this practice has been challenged; and a number of clinical reports have demonstrated no benefit, as judged by reduction of surgical site infections. This paper presents the advantages and disadvantages of mechanical bowel preparation. METHODS: Review of the pertinent English language literature. RESULTS: Some published studies support omission of mechanical preparation of the colon prior to elective colo-rectal surgery. However, the evidence is not definitive, in that the most rigorous study performed to date, a large, randomized trial, is non-confirmatory. CONCLUSIONS: Additional stratified studies of different mechanical bowel preparation methods, compared with no preparation, are required to address whether the practice should be abandoned.

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