Effect on the intestinal flora of preoperative bowel preparation for colorectal surgery.

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The fecal flora (anaerobes and aerobes) was examined in colorectal carcinoma patients, who were divided into three groups given different forns of preoperative bowel preparation. In group I, low-residual diet and kanamycin were used three days before the operation. In group II, Clinimeal was used instead of a low-residual diet and then kanamycin was employed. In group III, Clinimeal, kanamycin and metronidazole were adopted. On the first hospital day, three days before the operation and on the day of the operation, feces were examined. On admission, the log number of total anaerobes in 1 g feces was 10.6, and the majority of these were Bacteroidaceae. The log number of total aerobes was 8.6, and the majority of these were Enterobacteriaceae. After preoperative bowel preparation, total anaerobes were reduced to 7.9 in group I, 9.3 in group II and under 2 in group III. Aerobes were also reduced to 5.4 in group I and 5.7 in group II. However, in group III, aerobes did not decrease. Diet levels were 500 Cal/day in group I, and 2, 000 Cal/day in groups II and III.