Mechanical Bowel Preparation or Not for Elective Colorectal Surgery

Background: Mechanical bowel preparation has been a mainstay in the management of patients undergoing elective colorectal surgery, but in recent years, this practice has been challenged; and a number of clinical reports have demonstrated no benefit, as judged by reduction of surgical site infections. This paper presents the advantages and disadvantages of mechanical bowel preparation. Methods: Review of the pertinent English language literature. Results: Some published studies support omission of mechanical preparation of the colon prior to elective colorectal surgery. However, the evidence is not definitive, in that the most rigorous study performed to date, a large, randomized trial, is non-confirmatory. Conclusions: Additional stratified studies of different mechanical bowel preparation methods, compared with no preparation, are required to address whether the practice should be abandoned.