Bowel preparation before colectomy

摘要

Does bowel preparation before colectomy reduce surgical site infections, including anastomotic leak? This Finnish trial randomised people to either mechanical and oral antibiotic bowel preparation or no bowel preparation. It found no difference in the rates of surgical site infections between groups. Rates of anastomotic leak and re-operation were very similar. This is research the way it should be. The surgeons had an inkling that mechanical and oral antibiotic bowel preparation might be beneficial based on observational data, but this could be confounded by comorbidities causing some patients to be less likely to receive bowel preparation and also more likely to get surgical complications. A randomised study was essential, and the trial was well designed to answer the question, particularly by pushing for blinding of all staff as much as possible to avoid bias.