Optimizing Preoperative Care: Comparing Mechanical Bowel Preparation Alone Versus Combined Oral Antibiotics in Colorectal Cancer Surgery

Mechanical bowel preparation (MBP) is routinely used in colorectal surgeries to minimize postoperative infections, yet its role is debated. Combining MBP with oral antibiotics (OA) has shown promise in reducing surgical site infections (SSIs) and anastomotic leaks, particularly in high-risk procedures like colorectal cancer surgeries. Our aim was to compare the effectiveness of MBP alone versus MBP with OA in reducing SSIs, anastomotic leaks, and other postoperative complications in elective colorectal surgeries. This quasi-experimental study included 99 patients undergoing colorectal cancer surgery from July 2021 to July 2023. Patients were divided into two groups: group A (n = 33) received MBP alone, while group B (n = 66) received MBP with rifaximin. Postoperative outcomes, including SSIs, anastomotic leaks, ileus, and mortality, were assessed. Statistical significance was set at p < 0.05. Group B demonstrated a significantly lower incidence of SSIs (9% vs. 18%, p = 0.045) and anastomotic leaks (7.5% vs. 12%, p = 0.039) compared to group A. No significant differences were observed in ileus or mortality rates. No patient required readmission after discharge. Most patients tolerated MBP well. The combination of MBP and OA significantly reduced SSIs and anastomotic leaks in elective colorectal surgeries compared to MBP alone, without increasing adverse events. These findings support the integration of OA with MBP in preoperative protocols to enhance surgical outcomes and patient safety in colorectal cancer surgeries.