Faisabilité de la chirurgie colorectale sans préparation colique. Étude prospective

Abstract

Introduction Mechanical bowel preparation (MBP), aimed at reducing the infectious complications of colorectal surgery, was considered as indispensable. This benefits is actually disputed. The aim of this study was to report an experience of colorectal surgery without MBP. Materials and methods Hundred ninety patients without MBP and without low residue diet, who underwent colorectal surgery with primary anastomosis not requiring a diverting stoma were included. The main outcome were the rate of mortality, anastomotic leak, wound infection and intra-abdominal abscess. Secondary outcomes were duration of intravenous perfusion, nasogastric aspiration, total hospitalisation stay and time to realimentation. Results The procedure was performed by laparotomy ( n = 142) or laparoscopy ( n = 48). Forty-eight patients underwent emergency surgery. Ninety-two patients were operated for malignancy. The rate of mortality was 6.3% in correlation with the scale of AFC. The rate of anastomotic leak was 3.7%. The rate of specific morbidity was independent of scale of AFC on the contrary to the frequency of non-specific complications. The mean duration of intravenous perfusion and nasogastric suction were 6 days and 0.3 day. The patient had normal diet to the 4th day (4 ± 3 days). The mean hospital stay was 13.4 days. Conclusion The colorectal surgery without MBP may be safely performed and could improve the quality of life of patients in the perioperatoty period.