Bowel Preparation in Patients Undergoing Surgery for Rectal Cancer
Bowel Preparation in Patients Undergoing Surgery for Rectal Cancer
Bretagnol F, Panis Y, Rullier E, et al; French Research Group of Rectal Cancer Surgery (GRECCAR)
Ann Surg. 2010;252:863-868
Is bowel preparation prior to surgery for rectal cancer beneficial? The authors conducted a randomized trial of patients with (n = 89) and without (n = 89) bowel preparation. Endpoints were overall morbidity and infection-related morbidity. All patients received perioperative prophylactic antibiotics. One patient died, but the overall morbidity and infectious morbidity were both significantly increased in the group without mechanical bowel preparation (P = .018 vs P = .005, respectively). A trend toward increased rate of anastomotic leak in the non-bowel-preparation group was observed: 19% vs 10% (P = .09).
The authors point out that the use or nonuse of mechanical bowel preparation prior to colonic surgery is still controversial. With respect to rectal cancer, data are limited because rectal cancer patients were excluded in many of the reports on the use of bowel preparation in patients with colon cancer. This randomized trial raises questions about the wisdom of avoiding mechanical preoperative bowel preparation in patients with rectal cancer.
Abstract
Rectal Cancer Surgery With or Without Bowel Preparation: The French GRECCAR III Multicenter Single-Blinded Randomized Trial
Bretagnol F, Panis Y, Rullier E, et al; French Research Group of Rectal Cancer Surgery (GRECCAR)
Ann Surg. 2010;252:863-868
Summary
Is bowel preparation prior to surgery for rectal cancer beneficial? The authors conducted a randomized trial of patients with (n = 89) and without (n = 89) bowel preparation. Endpoints were overall morbidity and infection-related morbidity. All patients received perioperative prophylactic antibiotics. One patient died, but the overall morbidity and infectious morbidity were both significantly increased in the group without mechanical bowel preparation (P = .018 vs P = .005, respectively). A trend toward increased rate of anastomotic leak in the non-bowel-preparation group was observed: 19% vs 10% (P = .09).
Viewpoint
The authors point out that the use or nonuse of mechanical bowel preparation prior to colonic surgery is still controversial. With respect to rectal cancer, data are limited because rectal cancer patients were excluded in many of the reports on the use of bowel preparation in patients with colon cancer. This randomized trial raises questions about the wisdom of avoiding mechanical preoperative bowel preparation in patients with rectal cancer.
Abstract
