The Effect of Mechanical Bowel Preparation on Human Colonic Tissue in Elective Open Colon Surgery

Excerpt

To the Editor—Preoperative mechanical bowel preparation with osmotic laxatives is common practice in elective colorectal surgery. It is believed to reduce the risk of wound infection and anastomotic leakage and is supplemental to antibiotic prophylaxis in most surgical centers.1, 2, 3, 4, 5, 6 However, in reviewing the literature, I found that little is known about the side effects of osmotic laxatives on the intestinal tissue. We conducted a microscopic study to further evaluate the spectrum of the effects of bowel preparation in which 40 patients who underwent elective open colon surgery for nonobstructive malignancy were included. Patients with inflammatory bowel disease were excluded from the study, as were patients with clinical bowel obstruction. Patients who received radiotherapy or chemotherapy up to three weeks before surgery and immunocompromised patients also were excluded. …