The Effectiveness of Bowel Preparation in Reducing Anastomotic Leakage and Surgical Infection Rates in Colorectal Surgery

Abstract

The optimal bowel preparation strategy before elective colorectal surgery remains controversial. This prospective and retrospective comparative analytical study evaluated the impact of different bowel preparation methods on postoperative outcomes in 87 patients undergoing elective colorectal surgery at Latakia University Hospital, Syria. Patients were allocated to mechanical bowel preparation alone (MBP, n=25), combined mechanical and oral antibiotic bowel preparation (MOBP, n=28), or no bowel preparation (N-MBP, n=34). Anastomotic leakage occurred in 12%, 3.6%, and 5.9% of patients, respectively (p=0.04), while surgical site infection rates were 32%, 10.7%, and 29.4%, respectively (p=0.01). The lowest rates of leakage and infection were observed in the MOBP group, with a tendency toward shorter hospital stay. Combined mechanical and oral antibiotic bowel preparation was associated with significantly improved postoperative outcomes compared with mechanical preparation alone or no preparation. These findings support current international recommendations favoring combined bowel preparation before elective colorectal surgery.