Preparation with Mechanical Bowel Cleansing or/and Oral Antibiotics or Nothing for Elective Colorectal Surgery: Two-Two-Arm Multicentre Randomised Controlled Studies (MECCLANT –C and –R Trials)

During almost all the 20^th century and practically based on observational studies and experts opinion, mechanical bowel preparation (MBP) has been considered as necessary prior to colorectal surgery, in order to remove gross faecal and bacteria colonic load and thus to prevent anastomotic leakage and reduce septic postoperative complications. 

However, several more recent randomised clinical trials, meta-analyses, systematic reviews and surveys have consistently shown that MBP does not prevent either anastomotic leakage or surgical site infection (SSI), and does not reduce immediate postoperative morbidity or. Furthermore, MBP is costly, time consuming, harmful and unpleasant for the patient, and also impedes implementation of enhanced recovery programmes. As a result of the aforementioned evidence,it is recommended that MBP for colorectal surgery must be abandoned.(Read more)