Many societies have recommended that mechanical and oral antibiotics bowel preparation (MOABP) is protective against surgical site infections (SSIs) and reduces the length of hospital stay in patients that undergo colon (large bowel) surgery.
Consequently, it is a widely performed procedure before surgery for large bowels in many centres across the globe.
MOABP is a procedure usually performed on patients before undergoing bowel surgery. It aims to clean the bowel of faeces and other contaminants that could cause infection both during and after surgical operation. This is with a view to reducing adverse surgical outcomes in form of morbidity and deaths.
However, a new study is challenging this recommendation and researchers are calling for its review.
The study conducted by researchers in Finland shows that such a procedure is needless. They found that MOABP did not confer additional surgical benefits on the patients who got the procedure done when compared with those who did not.
The study published in the prestigious Lancet journal has the primary outcome of interest as surgical site infection within 30 days of surgery in the study participants.
Half of the total number of patients who participated in the study were grouped together for MOABP while the remaining half did not get MOABP before their large bowel surgery and so were randomised as no bowel preparation (NBP).
The results? No statistically significant difference in the primary outcome of interest.
The researchers noted:
MOABP does not reduce SSIs or the overall morbidity of colon surgery compared with NBP. We therefore propose that the current recommendations of using MOABP for colectomies to reduce SSIs or morbidity should be reconsidered.Excerpts from the report of the findings by the researchers on MOABP and NBP for large bowel surgery in Finland.
Citation: Laura Koskenvuo et al, Mechanical and oral antibiotic bowel preparation versus no bowel preparation for elective colectomy (MOBILE): a multicentre, randomised, parallel, single-blinded trial, The Lancet (2019). DOI: 10.1016/S0140-6736(19)31269-3