Current Trends in the Use of Bowel Preparation for Colorectal Surgery

Abstract

This article reviews recent findings in the use of bowel preparation for preventing infectious complications after colorectal surgery. Whereas mechanical bowel preparation (MBP) was formerly used routinely in combination with prophylactic non-absorbable oral antibiotics (OAs) and prophylactic intravenous antibiotics, there was a trend toward omitting OAs in the 1990s and early 2000s. Since the mid-2000s, the use of MBP has declined given evidence of the limited role of MBP alone in preventing infectious complications. However, recent studies have demonstrated favorable outcomes after MBP when used in combination with OAs. Results from recent studies have prompted surgeons to reexamine the appropriate regimen for preoperative bowel preparation. The principal question that should now be addressed by future research is whether OAs alone reduce surgical infectious complications after colorectal surgery.