结直肠手术肠道准备作用评估

Assessment for bowel preparation in elective colorectal surgery

结直肠手术前肠道准备的作用近年引发了广泛关注。机械性肠道准备作为结直肠手术前常规准备已近百年,而从20世纪70年代开始受到质疑,尤其在加速康复外科概念提出后,机械性肠道准备在欧洲指南中已被舍弃。但近年来的一些研究结果表明,机械性肠道准备联合口服抗生素能够显著降低结直肠手术后手术部位感染的发生率。如何看待这些争论并正确评估肠道准备在临床实践中的作用,须进行高质量的随机对照研究加以证明。

Preoperative bowel preparation before elective colon surgery remains a subject of debate within the surgical community. Mechanical bowel preparation （MBP） has become dogma before colorectal surgery for one hundred years. But it has been queried since 1970s. MBP has been omitted in enhanced recovery after surgery （ERAS） protocols in Europe. But in recent years, some studies have suggested that MBP with the use of oral antibiotics is effective in reducing surgical site infection （SSI） after elective colorectal surgery. Those reports arouse controversies. How to regard as those controversies？ How to assess the role of bowel preparation in clinical practice？ Maybe more high quality RCT studies can answer those questions.