The role of mechanical bowel preparation in patients undergoing elective ileostomy closure

Abstract

Background: Mechanical bowel preparation (MBP) includes cleansing of intestine from its contents by giving oral preparations before surgery to clear fecal material from bowel lumen. It had many proposed advantages that lacked evidence. Recently, due to many notable side effects, the use of MBP had been questioned. This study was performed to compare the surgical outcome with MBP and without MBP in ileostomy closure surgeries. Materials and Methods: The study was conducted on 80 patients who had ileostomy for more than 3 months. They were randomly divided into two groups of 40, each using computer-generated randomization. Group A patients received MBP on the evening before elective ileostomy closure while Group B patients did not receive any MBP. Postoperatively, patients were kept in the ward and monitored for any complications and total duration of stay in hospital. Results: The mean postoperative duration of paralytic ileus after ileostomy closure surgery with bowel preparation is 4.1 ± 1.4 days. Without bowel preparation, it is 3.9 ± 1.5 days (P > 0.05). The number of patients with anastomotic leak is 3 (7.5%) in the bowel preparation group and 3 (7.5%) in the group without bowel preparation (P > 0.05). Wound infection is present in 7 (17.5%) patients in the bowel preparation group and 10 (25%) patients in the group without bowel preparation. The number of patients needing surgical intervention in the course of management is 2 (5%) in Group A (with MBP) and 3 (7.5%) in Group B (without MBP). The mean duration of hospital stay with bowel preparation is 10.6 ± 3.6 days and without bowel preparation is 10.8 ± 3.5 days (P > 0.05). Conclusion: The above study concludes that there is no influence of MBP on surgical anastomosis in ileostomy closure surgeries.