Is mechanical bowel preparation necessary in bariatric surgery?

Abstract

Background: Historically, mechanical bowel preparation (MBP) is performed prior to bariatric procedures; but our counter parts in colorectal surgery have shown that no-MBP is non-inferior to MBP, in regard to post-operative complications. The purpose of our study was to show that no-MBP prior to bariatric surgery is also non-inferior to MBP.

Methods: A prospective, randomized, controlled trial was conducted on patients undergoing bariatric surgical procedures (Roux-en-Y Gastric Bypass, or Sleeve Gastrectomy). We randomized patients to MBP and no-MBP. Number of post-operative complications (intraabdominal abscess, anastomotic leak, acute kidney injury, dehydration), readmission, and wound infection for 30 days post-procedure was recorded.

Results: A total of 139 patients were enrolled with 71 in the MBP group and 68 in the no-MBP group. Complication rates were similar between the MBP and no-MBP (12.7% vs. 10.2%, respectively; p = 0.660). Median hospital length of stay was similar for MBP and no-MBP (1 vs. 1 day, respectively; p = 0.782). Hospital readmissions for MBP vs. no-MBP was, 4.4% vs. 5.6%, respectively (p = 1.000).

Conclusion: Mechanical bowel preparation is likely not necessary prior to bariatric procedures.

Keywords: Bariatric surgery; Complication; Mechanical bowel preparation; Roux-en-Y gastric bypass; Sleeve gastrectomy.