Preoperative bowel preparation before elective colorectal surgery

Despite progress that has been made in the field of elective colorectal surgery with the implementation of minimally invasive surgery and optimized perioperative management of patients, postoperative infectious complications still pose a problem. Whether optimized preparation of the patient can help prevent this has occupied surgeons for more than half a century. After having introduced bowel preparation over 50 years ago this strategy was partially abandoned towards an almost complete elimination of bowel preparation. The discussion at this time is no longer whether we should perform bowel preparation, but more whether mechanical bowel preparation in combination with oral antibiotics or possibly oral antibiotics alone are enough to lower the rate of infectious complications.