SynthesisAnnals of surgery2019
The Role of Oral Antibiotic Preparation in Elective Colorectal Surgery: A Meta-analysis.
Synthesis in Annals of surgery, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 86 papers, 11 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
86 citing papers in PubMed, 11 syntheses or guidelines pooled it, 182 citations in OpenAlex.
- Best evidence summary of non-pharmacological interventions for postoperative abdominal distension in gynecological laparoscopic.Frontiers in medicine · 2026Pooled it
- Risk and protective factors for postoperative anastomotic leakage in esophageal and gastrointestinal surgery: an umbrella review of meta-analyses and systematic reviews.International journal of surgery (London, England) · 2026Pooled it
- Preoperative mechanical bowel preparation versus no preparation for pediatric intestinal surgery: a systematic review and meta-analysis.Pediatric surgery international · 2025Pooled it
- The significance of perioperative glucocorticoids in the prevention of seroma formation after mastectomies: a systematic review and meta-analysis.Breast cancer research and treatment · 2025Pooled it
- The effect of preoperative mechanical bowel preparation in paediatric bowel surgery on postoperative wound related complications: A meta-analysis.International wound journal · 2024Pooled it
- Mechanical bowel preparation and antibiotics in elective colorectal surgery: network meta-analysis.BJS open · 2023Pooled it
- Is There a Role for Mechanical and Oral Antibiotic Bowel Preparation for Patients Undergoing Minimally Invasive Colorectal Surgery? A Systematic Review and Meta-analysis.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2023Pooled it
- Effect of wound protectors in reducing the incidence of surgical site wound infection in lower gastrointestinal surgery: A meta-analysis.International wound journal · 2023Pooled it
- Preoperative combined mechanical and oral antibiotic bowel preparation for preventing complications in elective colorectal surgery.The Cochrane database of systematic reviews · 2023Pooled it
- The clinical effectiveness of wound edge protectors in reducing surgical site infection after abdominal surgery: meta-analysis.BJS open · 2022Pooled it
- Antibiotic prophylaxis in colorectal surgery: are oral, intravenous or both best and is mechanical bowel preparation necessary?Techniques in coloproctology · 2020Pooled it
- Effect of oral antimicrobial prophylaxis on surgical site infection after elective colorectal surgery: multicentre, randomised, double blind, placebo controlled trial.BMJ (Clinical research ed.) · 2022Trial
- Trial
- Prevention of anastomotic leak in rectal cancer surgery with local antibiotic decontamination: a prospective, randomized, double-blind, placebo-controlled single center trial.International journal of colorectal disease · 2020Trial
- Optimal preoperative bowel preparation for intracorporeal anastomosis in laparoscopic colectomy.Surgical endoscopy · 2026Article
- Impact of an ERAS-Based Surgical Care Bundle Implementation for Preventing Anastomotic Leakage in Minimally Invasive Low Anterior Resection for Rectal Cancer: A Retrospective Cohort Study.World journal of surgery · 2026Article
- Risk and protective factors for anastomotic insufficiency in elective colon and rectal cancer resections - a multivariate analysis with over 700 patients.Langenbeck's archives of surgery · 2026Article
- Article
- Optimizing Surgical Antibiotic Prophylaxis in the Era of Antimicrobial Resistance: A Position Paper from the Italian Multidisciplinary Society for the Prevention of Healthcare-Associated Infections (SIMPIOS).Pathogens (Basel, Switzerland) · 2025Review
- Optimizing Preoperative Care: Comparing Mechanical Bowel Preparation Alone Versus Combined Oral Antibiotics in Colorectal Cancer Surgery.Indian journal of surgical oncology · 2025Article
26 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 4 institutions in 1 country.
Funding
Abstract
objectivesTo compare the impact of the use of oral antibiotics (OAB) with or without mechanical bowel preparation (MBP) on outcome in elective colorectal surgery. SUMMARY BACKGROUND DATA: Meta-analyses have demonstrated that MBP does not impact upon postoperative morbidity or mortality, and as such it should not be prescribed routinely. However, recent evidence from large retrospective cohort and database studies has suggested that there may be a role for combined OAB and MBP, or OAB alone in the prevention of surgical site infection (SSI).
methodsA meta-analysis of randomized controlled trials and cohort studies including adult patients undergoing elective colorectal surgery, receiving OAB with or without MBP was performed. The outcome measures examined were SSI, anastomotic leak, 30-day mortality, overall morbidity, development of ileus, reoperation and Clostridium difficile infection.
resultsA total of 40 studies with 69,517 patients (28 randomized controlled trials, n = 6437 and 12 cohort studies, n = 63,080) were included. The combination of MBP+OAB versus MBP alone was associated with a significant reduction in SSI [risk ratio (RR) 0.51, 95% confidence interval (CI) 0.46-0.56, P < 0.00001, I = 13%], anastomotic leak (RR 0.62, 95% CI 0.55-0.70, P < 0.00001, I = 0%), 30-day mortality (RR 0.58, 95% CI 0.44-0.76, P < 0.0001, I = 0%), overall morbidity (RR 0.67, 95% CI 0.63-0.71, P < 0.00001, I = 0%), and development of ileus (RR 0.72, 95% CI 0.52-0.98, P = 0.04, I = 36%), with no difference in Clostridium difficile infection rates. When a combination of MBP+OAB was compared with OAB alone, no significant difference was seen in SSI or anastomotic leak rates, but there was a significant reduction in 30-day mortality, and incidence of postoperative ileus with the combination. There is minimal literature available on the comparison between combined MBP+OAB versus no preparation, OAB alone versus no preparation, and OAB versus MBP.
conclusionsCurrent evidence suggests a potentially significant role for OAB preparation, either in combination with MBP or alone, in the prevention of postoperative complications in elective colorectal surgery. Further high-quality evidence is required to differentiate between the benefits of combined MBP+OAB or OAB alone.
Indexed as
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.