[Preoperative bowel conditioning].

Abstract

BACKGROUND\nGastrointestinal surgery is still associated with a relevant morbidity with the intestinal microbiome being of high importance in the pathogenesis of infectious complications. Various approaches, such as mechanical bowel preparation (MBP) with or without administration of oral antibiotics, fasting or dietary supplements aim at modulating the intestinal flora.\n\n\nOBJECTIVE\nThis review summarizes the current literature pertinent to the influence of preoperative bowel conditioning on postoperative morbidity.\n\n\nMATERIAL AND METHODS\nA\xa0literature search was performed using the mentioned keywords with a focus on recent meta-analyses.\n\n\nRESULTS AND CONCLUSION\nBowel conditioning reduces postoperative infectious complications. Promising approaches are MBP plus administration of oral antibiotics, dietary supplements aiming at stabilization of the intestinal flora as well as the screening for and equilibration of malnutrition. The use of MBP as monotherapy without antibiotics should no longer be considered part of the clinical routine.