Most surgeons have recommended bowel perparation prior to elective colo-rectal cancer operations. The rationale for this was that faecal loading increased the chance of anastamotis leaks and peritonitis. Some felt that if there was a small hole in the anastamosis then this may very well heal when the bowel was empty but had no chance to heal when the bowel was full of stool. This makes sense; however other research has shown the importance of luminal contents in providing nutrition to the bowel.
Some surgeons questioned the importance of bowel preparation and several randomised trials were done. A meta-analysis of these trials was recently published and this concluded that there was no convincing evidence for a beneficial effect of mechanical bowel preparation in elective colo-recatal surgery [WJGCM03].