Preoperative bowel preparation affects the prognosis of colorectal cancer after radical surgery: a systemic review

Abstract

Preoperative bowel preparation (PBP) for colorectal cancer (CRC) radical surgery (RS) is necessary and has been widely used in clinical practice. The previously adopted traditional bowel preparation (TBP) is associated with substantial complications such as intestinal congestion, water-electrolyte imbalance, reduced nutritional status, hyperemia and edema, and even leading to increased local recurrence (LR) and distant metastasis (DM) due to repeated stimulation of tumors. The current mainly clinical practice is fast preoperative bowel preparation (RBP), due to its convenient performance, good tolerance and less damage to the intestinal tract. But the laxatives of RBP through oral administration, decomposed to methane, which might result in forbidding the use of electric knife or electric coagulation, reduce the operation of hemostasis. Recently, some scholars suggest preoperative enteral nutrition (EN) for bowel preparation before surgery, which can improve patients nutritional status, promote postoperative recovery of intestinal function and do not increase postoperative complications such as infection. Here, we review the medical literature related to PBP for colorectal cancer patients before radical surgery, with highlights on their advantages, shortcomings, and their influence of short- and long-term outcomes. Key words: Colorectal neoplasms; Colorectal surgery; Enteral nutrition; Preoperative bowel preparation; Prognosis