Cleansing the large bowel with enemas is an unpleasant, time-consuming procedure that is unpopular with both patients and health professionals.
Dr Peer Wille-Jørgensen and coleagues reviewed the existing literature to establish whether bowel cleansing provides any clinical benefits.
Only randomized trials were included in the review. Outcome measures were surgical infections, mortality, and anastomotic leakage.
Anastomotic leakage occurred in 5.5% of procedures with cleansing compared with 2.9 % of procedures without cleansing.
Peritonitis was reported in 5.1% of procedures with preoperative cleansing compared to only 2.8% of cases without cleansing.
7.4% of procedures with bowel cleansing resulted in wound infection compared to 5.7% without cleansing.
| Cleansing seems to be associated with an increased risk of anastomotic leakage
|Diseases of the Colon and Rectum|
Dr Wille-Jørgensen concludes. “There is no evidence in the literature for beneficial effects from the use of bowel cleansing before elective colorectal surgery.”
Furthermore he adds. “Cleansing seems to be associated with an increased risk of anastomotic leakage”