Preoperative bowel cleansing

Abstract

Abstract Preoperative mechanical cleansing was initially proposed in the early 1950s. The mechanical bowel preparation has been regarded as essential in preventing postoperative complications in colorectal surgery. Nowadays, this concept is changing. Many trials, clinical and experimental, are showing there is no difference in the results between groups submitted to mechanical bowel preparation and those without preparation. The aim of this report is to describe the principal methods of mechanical bowel preparation, ie, conventional bowel preparation, elemental diets, whole bowel irrigation, oral mannitol bowel preparation, polyethylene glycol–based solution, sodium phosphate–based oral solution, intraoperative colonic lavage, and to present an overlook of the microbiology of the colon and the use of antimicrobial prophylaxis in elective and emergency colorectal surgery as well as in experimental studies. The necessity of preoperative bowel preparation before elective colorectal surgery is discussed. Copyright © 2002 by W.B. Saunders Company