For more than two centuries, surgeons have been performing operations on the colon
and rectum. This year more than 100,000 colorectal operations will be performed in
the United States alone [
[1]
]. Despite the abundant collective knowledge and experience of generations of surgeons,
colon operations continue to carry significant risks. Contemporary mortality rates
range from 1% to 2% for elective colorectal procedures [
[2]
]. Surgical site infections (SSIs), one of many sources of postoperative morbidity,
occur in nearly 10% of patients [
[2]
]. The authors’ experience with the Michigan Surgical Quality Collaborative (MSQC)
has shown that the range of morbidity rates across centers is broad, some centers
achieving rates 50% better than the average. While the etiology of this variation
in morbidity is likely multifactorial, it may be explained in part by difference in
practice patterns. Among the many aspects of the practice of colon surgery that merit
examination, preoperative bowel preparation has been the subject of particular and
long-standing controversy. Further investigation, informed by the body of data amassed
over the past 50 years, has the potential to define the optimal preoperative bowel
preparation, and so reduce the morbidity of colorectal surgery.To read this article in full you will need to make a payment
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