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Published in: Pediatric Surgery International 12/2018

01-12-2018 | Original Article

The value of mechanical bowel preparation prior to pediatric colorectal surgery: a systematic review and meta-analysis

Authors: Maarten Janssen Lok, Hiromu Miyake, Joshua S. O’Connell, Shogo Seo, Agostino Pierro

Published in: Pediatric Surgery International | Issue 12/2018

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Abstract

Purpose

The use of mechanical bowel preparation (MBP) before pediatric colorectal surgery remains the standard of care for many pediatric surgeons, though the value of MBP remains unclear. The aim of this study was to systematically review and analyze the effect of MBP on the incidence of postoperative complications; anastomotic leakage, intra-abdominal infection, and wound infection, following colorectal surgery in pediatric patients.

Methods

Embase, MEDLINE, Web of Science, and CINAHL databases were searched to compare the effect of MBP versus no MBP prior to elective pediatric colorectal surgery on postoperative complications. After critical appraisal of included studies, meta-analyses were conducted using a random-effect model.

Results

1731 papers were retrieved; 2 randomized controlled trials and 4 retrospective cohort studies met the inclusion criteria. The overall quality of evidence was low. MBP before colorectal surgery did not significantly decrease the occurrence of anastomotic leakage, intra-abdominal infection, or wound infection compared to no MBP.

Conclusions

On the basis of the existing evidence, the use of MBP before colorectal surgery in children seems not to decrease the incidence of postoperative complications compared to no MBP. To overcome confounding factors such as antibiotic prophylaxis, age and type of operation, a multicentre prospective study is suggested to validate these results.
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Metadata
Title
The value of mechanical bowel preparation prior to pediatric colorectal surgery: a systematic review and meta-analysis
Authors
Maarten Janssen Lok
Hiromu Miyake
Joshua S. O’Connell
Shogo Seo
Agostino Pierro
Publication date
01-12-2018
Publisher
Springer Berlin Heidelberg
Published in
Pediatric Surgery International / Issue 12/2018
Print ISSN: 0179-0358
Electronic ISSN: 1437-9813
DOI
https://doi.org/10.1007/s00383-018-4345-y

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