Comparison of Mechanical Bowel Preparation Versus Enema for Candidates to Colorectal Resection for Adenocarcinoma (MBP)

European Institute of Oncology

Status: Completed

Conditions: Colorectal Cancer

Treatments: Other: mechanical bowel preparation; Other: enema

Study type: Interventional

Funder types: Other

Identifiers

NCT00940030

IEO S357/307

Details and patient eligibility

About

The purpose of this study is to evaluate mechanical bowel preparation (MBP) with polyethylene glycol plus bowel enema versus bowel enema alone in patients candidates to colorectal resection for malignancy.

Full description

Surgical site infections (SSI) in colorectal surgery (anastomotic leakage, wound infection, intraabdominal abscess) are associated with increased mortality, postoperative hospital stay and costs. From a recent metanalysis and randomized clinical trial there is the emerging evidence that mechanical bowel preparation (MBP) before elective colorectal surgery is not associated with reduction of SIS, although it causes high discomfort for patients. On the same way other more recent studies show that MBP may cause an higher incidence of SIS, and that MBP may alter the bowel mucosa morphology. Other Authors report an increased incidence of anastomotic leakage requiring surgery for patients undergoing a single preoperative phosphate enema whereas but an higher cardiovascular mortality for patients undergoing MBP. Two recent studies do not clarify the usefulness of MBP for reducing SIS after colorectal surgery and one stage anastomosis. For these reasons a more precise understanding of the relationship between MBP and SIS could increase patients satisfaction and decrease unnecessary procedures and costs. At this point MBP represent the clinical standard for patients undergoing elective colorectal surgery at the European Institute of Oncology.

Enrollment: 440 patients

Sex: All

Ages: 18 to 80 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Patients candidates to colorectal surgery for histologically confirmed colorectal cancer
• Age 18-80 years
• Obtained written consent

Exclusion criteria

• Patients at high risk for receiving a stoma (e. g. patients affected by distal rectal cancer <5cm from the anal verge; patients whose tumour is located >5 cm from the anal verge who underwent neoadjuvant CT-RT without downstaging or tumour shrinkage
• Intestinal obstruction
• Emergency procedures
• Patients who underwent colonoscopy within 7 day from surgery
• ASA 4-5 patients
• Patients unable to give informed consent
• Renal failure (serum creatinine >3 mg/dl)
• Pregnant women
• Breast feeding women

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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440 participants in 2 patient groups

MBP+enema

Experimental group

Description:

mechanical bowel preparation and enema

Treatment:

Other: mechanical bowel preparation

Other: enema

enema

Active Comparator group

Treatment:

Other: enema