Conclusion Based on the current literature , there is insufficient evidence to indicate that the use of MBP leads to a significant difference in the risk of developing infectious complications in pediatric colorectal surgery
Objectives To evaluate whether the application of mechanical bowel preparation ( MBP ) before colorectal surgery reduces the risk of developing infectious complications in children .
Effect of preadmission bowel preparation on outcomes of elective colorectal procedures in young children.
BACKGROUND The utility of mechanical bowel preparation ( MBP ) to minimize infectious complications in elective colorectal surgery is contentious . Though data is scarce in children , adult studies suggest a benefit to MBP when administered with oral antibiotics ( OAB ) . METHODS After IRB approval , the Pediatric Health Information System ( PHIS ) was queried for young children undergoing elective colon surgery from 2011 to 2014 . Patients were divided into : no bowel preparation ( Group 1 ) , MBP ( Group 2 ) , and MBP plus OAB ( Group 3 ) . Statistical significance was determined using univariate and multivariate analysis with GEE models accounting for clustering by hospital . RESULTS One thous and five hundred eighty-one patients met study criteria : 63.7 % in Group 1 , 27.1 % in Group 2 , and 9.2 % in Group 3 .  Surgical complication rate was higher in Group 1 ( 23.3 % ) compared to Groups 2 and 3 ( 14.2 % and 15.5 % ; P<0.001 ) . However , median length of stay was shorter in Group 1 ( 4 , IQR 4days ) compared to Group 2 ( 5 , IQR 3 ) and Group 3 ( 6 , IQR 3 ) ( P<0.001 ) . 30-day readmission rates were similar . In multivariate analysis compared to patients in Group 1 , the odds of surgical complications were 0.72 ( 95 % CI 0.40 - 1.29 , P=0.28 ) with MBP alone ( Group 2 ) , 1.79 ( 95 % CI 1.28 - 2.52 , P=0.0008 ) with MBP+OAB ( Group 3 ) , and 1.13 ( 95 % CI 0.81 - 1.58 , P=0.46 ) for the aggregate Group 2 plus 3 . CONCLUSION Utilization of bowel preparation in children is variable across children 's hospitals nationally , and the benefit is unclear . Given the discrepancy with adult literature , a three-armed pediatric-specific r and omized controlled trial is warranted . LEVEL OF EVIDENCE Level III treatment study - retrospective comparative study
Conclusion Based on the current literature , there is insufficient evidence to indicate that the use of MBP leads to a significant difference in the risk of developing infectious complications in pediatric colorectal surgery
Objectives To evaluate whether the application of mechanical bowel preparation ( MBP ) before colorectal surgery reduces the risk of developing infectious complications in children .