Current practice in bowel preparation for colorectal surgery: a survey of the members of the Association of Coloproctology of GB & Ireland

Abstract

Aim: Recent meta-analyses have suggested that mechanical bowel preparation is not beneficial in patients undergoing colorectal resection. This study aimed to assess current surgical practice in the UK.

Method: Three hundred and ninety-eight members of the Association of Coloproctology of GB & Ireland were invited to complete an online survey to ascertain their current practice for bowel preparation.

Results: One hundred and ninety-nine surgeons completed the survey, of whom 95 (48%) routinely performed laparoscopic resection. The proportions using full bowel preparation for open vs laparoscopic surgery were, respectively, 9.5%vs 16.8% for right hemicolectomy, 43.4%vs 40.2% for left hemicolectomy, 20.5%vs 22.5% for an abdominoperineal resection and 72.2%vs 63.6% for low anterior resection. Among the surgeons who participated, 13.6% changed their practice between doing the same procedure open and laparoscopically, 76% of surgeons routinely defunctioned a low anterior resection. Of these, 22% did not feel that full bowel preparation was necessary before formation of an ileostomy.

Conclusion: The study demonstrates that a large proportion of patients still receive full bowel preparation despite recent advice to the contrary.