Abstract

META-ANALYSIS: ORAL MECHANICAL BOWEL PREPARATION IN COLORECTAL SURGERY

Abdulmajeed Abdulrazaq Alzahrani*, Mohammad Abdulrahman Aldehami, Majed Ghunayman Alharbi, Abdulrahman Abdullah Aldosery and Muath Mohammed Aldukhayel

Abstract

Background & Purpose: In latest years, OMBP has come under increasing scrutiny. patients frequently document that OMBP solutions have an unpleasant taste, and some experience dehydration and electrolyte derangements. Moreover, numerous current trials have didn't pick out a statistically enormous benefit to using OMBP before colon surgical procedure. Bringing up a number of these trials, the 2010 recommendations of the Canadian Society of Colon and Rectal Surgeons preferred omitting OMBP in the preoperative management of patients undergoing elective open right-sided and left sided colorectal surgical resections but deemed the evidence inadequate to aid or refute omitting OMBP for sufferers undergoing low anterior resection (without or with diverting stomas) and those undergoing laparoscopic colorectal surgical treatment. The Aim of this work is to provide cumulative data about the effect of oral mechanical bowel preparation (OMBP) versus no preparation or enema for colorectal surgery patients. Methods: A systematic search was performed of PubMed, Cochrane library Ovid, Scopus & Google scholar to identify Surgery RCTs, clinical trials, and comparative studies, which studied the outcome of OMBP group versus No preparation group of colorectal surgery patients. A meta-analysis was done using fixed and random-effect methods. The primary outcome was anastomotic leakage. Secondary outcome was surgical site infection. Results: A total of 6 studies were identified involving 11340 patients, with 7710 patients in OMBP group, and 3630 patients in No preparation group. Regarding primary outcome measure, the fixed-effects model of the meta- analysis study showed highly significant decrease in anastomotic leakage in OMBP group compared to No preparation group (p = 0.003). Regarding secondary outcome measure, the random-effects model of the meta- analysis study showed non-significant difference in surgical site infection in both groups (p > 0.05). Conclusion: To conclude, OMBP play a very important role in prevention of surface site infection and decreasing anastomotic leakage in colorectal surgery, this effect increases by using antibiotics with OMBP.

Keywords: Oral Mechanical Bowel Preparation, Colorectal Surgery.