A Chinese Survey of Current Practice Patterns of Preoperative Bowel Preparation in Colorectal Surgery

Abstract

Background Bowel preparation has long been considered as the standard preoperative management for colorectal surgery. However, there are still controversies about bowel preparation and the importance of bowel preparation gradually declined. The purpose of this study is to describe the current attitudes and practice patterns of preoperative bowel preparation among Chinese surgeons. Methods An online 11-question anonymous survey was randomly assigned to Chinese surgeons. The questionnaire sought information on each surgeon’s current practice of preoperative bowel preparation. Results 384 Chinese surgeons from 26 provincial administrative regions took part in this survey. The most common reason for choosing bowel preparation was preventing surgical site infection (SSI). Meanwhile, 74% Chinese surgeons believed bowel preparation could avoid anastomotic leakage. Only 34% thought that bowel preparation was considered to reduce risk of postoperative bleeding. In terms of bowel preparation methods, 57% Chinese surgeons preferred to choose laxatives alone. Regarding the choices of agents, Chinese surgeons were more likely to choose polyethylene glycol-electrolyte lavage solution (PEG-ELS). Conclusions Surgeons choose bowel preparation mostly to avoid SSI and anastomotic leakage, and they prefer using laxatives alone. Our study shows that surgeons do not have clear guidelines that can govern their clinical practice and there are still controversies about bowel preparation. Further study is required to provide strong evidences to inform clinical and policy decisions.