Introduction

Until now, mechanical bowel preparation (MBP) has been absolutely a dogma before colorectal surgery, as stated by Slim in 2004 [1]. However, MBP has been questioned during the last few years in many papers and especially in some meta-analysis published in the scientific literature. Some papers and reviews have stressed the uselessness of MBP. However, MBP is useful for cleaning the colon and removing firm faeces from the rectum both by oral laxative drugs, such as polyethyleneglycol, or by enema [2]. The advantage is easier management of viscus, and less possibility of outspreading faeces during surgery. Moreover, cleaning makes it easier to perform a colonoscopy if necessary, while reducing the hazard of damaging the colonic wall during laparoscopic surgery [3]. Also, the hazard of sepsis is reduced if a dehiscence of anastomosis occurs.

Disadvantages of the procedure are patient discomfort, such as nausea, swelling, bloating, dehydration and electrolyte disturbances, and a higher social cost for these drugs. Already more than 30 years ago a randomised trial questioned this issue [4], and during the last 10 years many trials and some meta-analysis has demonstrated the uselessness of MBP for prevention of septic complications and anastomosis dehiscence onset.

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