Tolerability and impact on postoperative morbidity of
preoperative bowel preparation in Crohn's disease patients:
results of prospective observational study

J 2026

Tolerability and impact on postoperative morbidity of preoperative bowel preparation in Crohn's disease patients: results of prospective observational study

IESALNIEKS, Igors; Aline SCHMITZ; Nils HINRICHS; Dominika IVANECKÁ; Zdeněk KALA et al.

Základní údaje

Originální název

Tolerability and impact on postoperative morbidity of preoperative bowel preparation in Crohn's disease patients: results of prospective observational study

Autoři

IESALNIEKS, Igors; Aline SCHMITZ; Nils HINRICHS; Dominika IVANECKÁ; Zdeněk KALA; Tomáš GROLICH a Lumír KUNOVSKÝ

Vydání

International Journal of Colorectal Disease, New York, Springer, 2026, 0179-1958

Další údaje

Jazyk

angličtina

Typ výsledku

Článek v odborném periodiku

Obor

30219 Gastroenterology and hepatology

Stát vydavatele

Spojené státy

Utajení

není předmětem státního či obchodního tajemství

Odkazy

URL

Impakt faktor

Impact factor: 2.300 v roce 2024

Označené pro přenos do RIV

Ano

Organizační jednotka

Lékařská fakulta

Klíčová slova anglicky

Bowel resection; Crohn's disease; Mechanical bowel preparation; Oral antibiotics; Posoperative complications; Surgery

Štítky

14110223, rivok

Příznaky

Mezinárodní význam, Recenzováno

Změněno: 9. 3. 2026 12:05, Mgr. Tereza Miškechová

Anotace

V originále

Background Preoperative mechanical bowel preparation (MBP) and oral antibiotics (OA) are widely used to decrease the risk of postoperative septic complications after colorectal resections. Unfortunately, it is not clear whether bowel preparation can lead to symptoms of small bowel obstruction, which might even increase the risk of postoperative morbidity. Methods Consecutive Crohn's disease patients undergoing bowel resections with formation of ileocolic or colocolic anastomosis were included in the present prospective observational study. Urgent surgery, surgery without preoperative MBP, colorectal cancer, and fecal diversion were exclusion criteria. A polyethylene glycol solution (2 L) was used for MBP. OA consisted of paramomycin and metronidazole taken at 7 p.m. and 11 p.m. at the evening before surgery. Occurrence of complications at the anastomotic site (leakage, peritonitis, abscess, or fistula in direct proximity to the anastomosis) was a primary outcome measure. Complications of MBP were recorded. Mechanical bowel preparation was defined as "incomplete" when patients took a lesser amount of MBP solution than scheduled. Results Between 2016 and 2024, ileocolic or colorectal resections with formation of an anastomosis were performed in 284 patients with Crohn's disease. Nausea, vomiting, or abdominal pain occurred during the MBP in 29% of patients (n = 78), leading to termination of intake in 53 patients (19%). Women (p < 0.001), patients hospitalized urgently because of acute abdominal pain (p = 0.008), patients presenting with severe anemia before surgery (p = 0.007), and patients scheduled for resections completed by ileocolic anastomosis as opposed to colocolic or colorectal anastomosis (p = 0.01) demonstrated a significantly increased risk of incomplete MBP. Thirty-two percent of patients demonstrated apparent dilatation of small bowel at the time of surgery. The incidence of anastomotic complications was 4% in patients who were able to complete MBP and 7.5% after an incomplete MBP (p = 0.27). There were no deaths. The conversion rate from laparoscopy to open surgery was increased in patients with small bowel dilatation (17% vs. 6%); however, the difference was not statistically significant (p = 0.13). Conclusion There is a considerable incidence of obstructive symptoms after preoperative mechanical bowel preparation in Crohn's disease patients. Nevertheless, an incomplete MBP is not associated with increased risk of intra- or postoperative complications and can be used safely in that particular population.

Citovat

IESALNIEKS, Igors; Aline SCHMITZ; Nils HINRICHS; Dominika IVANECKÁ; Zdeněk KALA; Tomáš GROLICH a Lumír KUNOVSKÝ. Tolerability and impact on postoperative morbidity of preoperative bowel preparation in Crohn's disease patients: results of prospective observational study. International Journal of Colorectal Disease. New York: Springer, 2026, roč. 41, č. 1, s. 1-9. ISSN 0179-1958. Dostupné z: https://doi.org/10.1007/s00384-026-05084-z.

@article{2559279,
   author = {Iesalnieks, Igors and Schmitz, Aline and Hinrichs, Nils and Ivanecká, Dominika and Kala, Zdeněk and Grolich, Tomáš and Kunovský, Lumír},
   article_location = {New York},
   article_number = {1},
   doi = {https://doi.org/10.1007/s00384-026-05084-z},
   keywords = {Bowel resection; Crohn's disease; Mechanical bowel preparation; Oral antibiotics; Posoperative complications; Surgery},
   language = {eng},
   issn = {0179-1958},
   journal = {International Journal of Colorectal Disease},
   title = {Tolerability and impact on postoperative morbidity of preoperative bowel preparation in Crohn's disease patients: results of prospective observational study},
   url = {https://link.springer.com/article/10.1007/s00384-026-05084-z},
   volume = {41},
   year = {2026}
}

TY  - JOUR
ID  - 2559279
AU  - Iesalnieks, Igors - Schmitz, Aline - Hinrichs, Nils - Ivanecká, Dominika - Kala, Zdeněk - Grolich, Tomáš - Kunovský, Lumír
PY  - 2026
TI  - Tolerability and impact on postoperative morbidity of preoperative bowel preparation in Crohn's disease patients: results of prospective observational study
JF  - International Journal of Colorectal Disease
VL  - 41
IS  - 1
SP  - 1-9
EP  - 1-9
PB  - Springer
SN  - 01791958
KW  - Bowel resection
KW  - Crohn's disease
KW  - Mechanical bowel preparation
KW  - Oral antibiotics
KW  - Posoperative complications
KW  - Surgery
UR  - https://link.springer.com/article/10.1007/s00384-026-05084-z
N2  - Background Preoperative mechanical bowel preparation (MBP) and oral antibiotics (OA) are widely used to decrease the risk of postoperative septic complications after colorectal resections. Unfortunately, it is not clear whether bowel preparation can lead to symptoms of small bowel obstruction, which might even increase the risk of postoperative morbidity. Methods Consecutive Crohn's disease patients undergoing bowel resections with formation of ileocolic or colocolic anastomosis were included in the present prospective observational study. Urgent surgery, surgery without preoperative MBP, colorectal cancer, and fecal diversion were exclusion criteria. A polyethylene glycol solution (2 L) was used for MBP. OA consisted of paramomycin and metronidazole taken at 7 p.m. and 11 p.m. at the evening before surgery. Occurrence of complications at the anastomotic site (leakage, peritonitis, abscess, or fistula in direct proximity to the anastomosis) was a primary outcome measure. Complications of MBP were recorded. Mechanical bowel preparation was defined as "incomplete" when patients took a lesser amount of MBP solution than scheduled. Results Between 2016 and 2024, ileocolic or colorectal resections with formation of an anastomosis were performed in 284 patients with Crohn's disease. Nausea, vomiting, or abdominal pain occurred during the MBP in 29% of patients (n = 78), leading to termination of intake in 53 patients (19%). Women (p < 0.001), patients hospitalized urgently because of acute abdominal pain (p = 0.008), patients presenting with severe anemia before surgery (p = 0.007), and patients scheduled for resections completed by ileocolic anastomosis as opposed to colocolic or colorectal anastomosis (p = 0.01) demonstrated a significantly increased risk of incomplete MBP. Thirty-two percent of patients demonstrated apparent dilatation of small bowel at the time of surgery. The incidence of anastomotic complications was 4% in patients who were able to complete MBP and 7.5% after an incomplete MBP (p = 0.27). There were no deaths. The conversion rate from laparoscopy to open surgery was increased in patients with small bowel dilatation (17% vs. 6%); however, the difference was not statistically significant (p = 0.13). Conclusion There is a considerable incidence of obstructive symptoms after preoperative mechanical bowel preparation in Crohn's disease patients. Nevertheless, an incomplete MBP is not associated with increased risk of intra- or postoperative complications and can be used safely in that particular population.
ER  -

IESALNIEKS, Igors; Aline SCHMITZ; Nils HINRICHS; Dominika IVANECKÁ; Zdeněk KALA; Tomáš GROLICH a Lumír KUNOVSKÝ. Tolerability and impact on postoperative morbidity of preoperative bowel preparation in Crohn's disease patients: results of prospective observational study. \textit{International Journal of Colorectal Disease}. New York: Springer, 2026, roč.~41, č.~1, s.~1-9. ISSN~0179-1958. Dostupné z: https://doi.org/10.1007/s00384-026-05084-z.

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