Waqas, Yousaf Jan, Aziz-ur Rahman, Ahmad Din.
Comparison of Efficacy of Primary Anastomosis of Large Bowel with Bowel Preparation Vs without Bowel Preparation.
Ophthalmol Update Jan ;12(3):225-9.

Introduction: Mechanical bowel preparation prior to surgery has been used for many years aiming at cleaning the large bowel of faecal matter and it is considered important in preventing postoperative complications including wound infection, intra-abdominal abscess and anastomotic leak. Objective: To compare the effectiveness of primary anastomosis of large bowel with bowel preparation versus without bowel preparation. Materials and Methods: This study was conducted in the Department of Surgery, Hayatabad Medical Complex, Peshawar from October 2010 to October 2012. Through a randomized controlled trial design of study, a total of 284 patients presenting with carcinoma colon, diverticulitis, volvulus of large bowel and trauma to large bowel were included and randomly allocated in two groups (group A with pre operative mechanical bowel preparation and group B with no pre operative mechanical bowel preparation). Both groups were subjected to primary anastomosis and were followed for the occurrence of anastomosis leak. Results: The mean age of the patients in group A was 41.547 + 7.762 and that of group B was 41.375 + 8.604. In group A, there were 53.52% males and 46.5% females while in group B there were 48.6% males and 51.4% females. Anastomosis leak was observed in 16.9% patients of group A and 12% patients of group B representing 83.1% effectiveness of mechanical bowel preparation prior to primary anastomosis and 88% effectiveness of no preparation. The difference was statistically insignificant (P value 0.238) Conclusion: Since there was no significant difference in the effectiveness of both the groups, we strongly conclude that there is no need of any mechanical bowel preparation before primary anastomosis of the large bowel as it will reduce the burden on our hospitals which are already resource limited.

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