Cochrane · systematic review · CD014909
Preoperative combined mechanical and oral antibiotic bowel preparation for preventing complications in elective colorectal surgery
Willis, MA, Toews, I, Soltau, SLV, et al. · Cochrane Database of Systematic Reviews · 2023 · Cochrane Library
ColorectalAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
15
current version
GRADE rated
15
No studies
0
Included studies
NR
No studies 0 · 0%Ungraded 0 · 0%Very low 1 · 6.7%Low 9 · 60%Moderate 5 · 33.3%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Summary of findings table ‐ Combined mechanical and oral antibiotic bowel preparation versus mechanical bowel preparation alone
Population: Patients undergoing elective colorectal surgery
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
SSI Summary of findings table ‐ Combined mechanical and oral antibiotic bowel preparation vs mechanical bowel preparation alone | RR 0.56 [0.42, 0.74] | 16 studies · 3917 participants | Moderate Downgraded: inconsistency |
Anastomotic leakage Summary of findings table ‐ Combined mechanical and oral antibiotic bowel preparation vs mechanical bowel preparation alone | RR 0.6 [0.36, 0.99] | 10 studies · 2356 participants | Moderate Downgraded: imprecision |
Mortality Summary of findings table ‐ Combined mechanical and oral antibiotic bowel preparation vs mechanical bowel preparation alone | RR 0.87 [0.27, 2.82] | 3 studies · 639 participants | Moderate Downgraded: imprecision |
Incidence of postoperative ileus Summary of findings table ‐ Combined mechanical and oral antibiotic bowel preparation vs mechanical bowel preparation alone | RR 0.89 [0.59, 1.32] | 6 studies · 2013 participants | Low Downgraded: imprecision |
Length of hospital stay Summary of findings table ‐ Combined mechanical and oral antibiotic bowel preparation vs mechanical bowel preparation alone | no estimate extracted | 3 studies · 621 participants | Moderate Downgraded: imprecision |
Summary of findings table ‐ Combined mechanical and oral antibiotic bowel preparation versus oral antibiotics alone
Population: Patients undergoing elective colorectal surgery
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Surgical site infections Summary of findings table ‐ Combined mechanical and oral antibiotic bowel preparation vs oral antibiotics alone | RR 0.87 [0.34, 2.21] | 3 studies · 960 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Anastomotic leakage Summary of findings table ‐ Combined mechanical and oral antibiotic bowel preparation vs oral antibiotics alone | RR 0.84 [0.21, 3.45] | 3 studies · 960 participants | Low Downgraded: risk of bias, imprecision |
Mortality Summary of findings table ‐ Combined mechanical and oral antibiotic bowel preparation vs oral antibiotics alone | RR 1.02 [0.3, 3.5] | 2 studies · 709 participants | Low Downgraded: risk of bias, imprecision |
Incidence of postoperative ileus Summary of findings table ‐ Combined mechanical and oral antibiotic bowel preparation vs oral antibiotics alone | RR 1.25 [0.68, 2.33] | 2 studies · 709 participants | Low Downgraded: risk of bias, imprecision |
Length of hospital stay Summary of findings table ‐ Combined mechanical and oral antibiotic bowel preparation vs oral antibiotics alone | no estimate extracted | 2 studies · 2 participants | Moderate Downgraded: risk of bias |
Summary of findings table ‐ Combined mechanical and oral antibiotic bowel preparation versus no bowel preparation
Population: Patients undergoing elective colorectal surgery
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Surgical site infections Summary of findings table ‐ Combined mechanical and oral antibiotic bowel preparation vs no bowel preparation | RR 0.63 [0.33, 1.23] | 1 study · 396 participants | Low Downgraded: imprecision |
Anastomotic leakage Summary of findings table ‐ Combined mechanical and oral antibiotic bowel preparation vs no bowel preparation | RR 0.89 [0.33, 2.42] | 1 study · 396 participants | Low Downgraded: imprecision |
Mortality Summary of findings table ‐ Combined mechanical and oral antibiotic bowel preparation vs no bowel preparation | RR 0.2 [0.01, 4.22] | 1 study · 396 participants | Low Downgraded: imprecision |
Incidence of postoperative ileus Summary of findings table ‐ Combined mechanical and oral antibiotic bowel preparation vs no bowel preparation | RR 1.18 [0.77, 1.81] | 1 study · 396 participants | Low Downgraded: imprecision |
Length of hospital stay Summary of findings table ‐ Combined mechanical and oral antibiotic bowel preparation vs no bowel preparation | no estimate extracted | 1 study · 396 participants | Low Downgraded: imprecision |