The impact of bowel preparation on the severity of anastomotic leak in colon cancer patients.
BACKGROUND AND OBJECTIVES
The routine use of preoperative bowel preparation (BP) is heavily debated in the colorectal surgery literature. To date, no study has investigated the effect preoperative BP has on patients with an established anastomotic leak. We therefore seek to compare the severity of patient morbidity and mortality in patients with a known anastomotic leak based on type of preoperative BP using the Targeted Colectomy American College of Surgeons National Surgery Quality Improvement Program (ACS-NSQIP).


METHODS
All elective colon cancer operations performed with primary anastomosis were identified within the targeted colectomy database from 2012 to 2013. Patients who experienced a postoperative anastomotic leak were identified and stratified based on preoperative BP. Variables that had an association with mechanical BP at P < 0.10 were included in a multivariate logistic regression model to determine if BP was independently associated with postoperative morbidity and mortality.


RESULTS
A total of 6,297 patients underwent elective colon resection with primary anastomosis for colon cancer. Two hundred and nineteen (3.5%) patients experienced an anastomotic leak. Thirty-day wound morbidity and mortality was not worse in patients who underwent preoperative BP.


CONCLUSIONS
BP is not associated with worse patients outcomes in those patients with an established anastomotic leak following elective colon research with primary anastomosis. J. Surg. Oncol. 2016;114:810-813. © 2016 2016 Wiley Periodicals, Inc.
['Haskins|Ivy N|IN|', 'Fleshman|James W|JW|', 'Amdur|Richard L|RL|', 'Agarwal|Samir|S|']
D000284:Administration, Oral D000328:Adult D000368:Aged D057868:Anastomotic Leak D000900:Anti-Bacterial Agents D019072:Antibiotic Prophylaxis D003082:Colectomy D003110:Colonic Neoplasms D016208:Databases, Factual D017558:Elective Surgical Procedures D005260:Female D006801:Humans D016015:Logistic Models D008297:Male D008875:Middle Aged D015999:Multivariate Analysis D011300:Preoperative Care D012189:Retrospective Studies D012307:Risk Factors D012720:Severity of Illness Index D016896:Treatment Outcome
bowel preparation anastomotic leak colon cancer colectomy