• Ahmad Elnahas, David Urbach, Gerald Lebovic, Muhammad Mamdani, Allan Okrainec, Fayez A Quereshy, and Timothy D Jackson.
• Division of General Surgery, Department of Surgery, University Health Network, University of Toronto, 399 Bathurst Street, Toronto, Ontario, M5T 2S8, Canada.
• Am. J. Surg. 2015 Nov 1;210(5):793-8.

BackgroundRoutine preoperative mechanical bowel preparation (MBP) for left-sided colorectal resections remains controversial. This study aims to evaluate the association between MBP and 30-day anastomotic leaks.MethodsA retrospective cohort study was conducted using data from the National Surgical Quality Improvement Program from 2011 to 2012. Multiple imputation was used for missing data, and a multivariable logistic regression was performed to adjust for clinically relevant variables. A propensity score-adjusted model was performed as a sensitivity analysis.ResultsA total of 2,581 patients (57%) received preoperative MBP, whereas 1,935 (43%) did not. The 30-day anastomotic leak rate with and without preoperative MBP was 3.1% and 5.1%, respectively. After covariate adjustment, MBP omission was significantly associated with a 40% increased odds of 30-day anastomotic leaks (odds ratio 1.41, P = .04, 95% confidence interval 1.01 to 1.93).ConclusionsMBP omission was associated with a higher rate of 30-day anastomotic leaks. A large, well-designed, randomized controlled trial is needed to further evaluate this relationship.Copyright © 2015 Elsevier Inc. All rights reserved.

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