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 18 February 2018

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News

Phosphate enema bowel preparation increases anastomotic leaks

The latest British Journal of Surgery shows that, compared with oral polyethylene, bowel preparations with a phosphate enema before elective colorectal surgery may increase the risk of anastomotic leakage, requiring re-operation.

News image

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A recent meta-analysis has questioned the value of bowel preparation in patients undergoing colorectal resection.

Dr Platell and colleagues evaluated whether a single phosphate enema was as effective as oral polyethylene glycol solution in preventing anastomotic leakage.

Patients were randomized to receive either a single phosphate enema or 3 litres of oral polyethylene glycol solution before surgery.

The research team followed patients for a minimum of 6 weeks to detect anastomotic leakage.

4% in the enema group had anastomotic leaks vs 0% in the polyethylene glycol group
British Journal of Surgery

There were 147 patients in each group and the groups were evenly matched for putative risk factors at baseline.

Patients in the enema group had more anastomotic leaks requiring reoperation, at 4%, with none occurring in the polyethylene glycol group.

The researchers observed that the mortality rate was higher in the polyethylene glycol group, although this was not statistically significant.

Dr Platell's team concluded, “Bowel preparation with a phosphate enema was associated with an increased risk of anastomotic leakage requiring reoperation compared with oral polyethylene glycol.”

“These results do not support the routine use of a phosphate enema in patients undergoing elective colorectal surgery.”

Br J Surg 2006: 93(4): 427-33
07 April 2006

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