Morbidity after mechanical bowel preparation and oral antibiotics prior to rectal resection. The MOBILE2 randomized clinical trial.

Traeger L, Bedrikovetski S, Fitzsimmons T, Nguyen T-M, Moore JW, Lewis M et al.

Br J Surg 2024; 111: znae121.

Pyridostigmine 60mg given orally twice daily after surgery reduced the duration of ileus by one day, measured by the GI-2 tool (P=0.015) in this study that included 130 patients, but did not affect the duration of hospital stay.

Comment: Apart from speeding return of bowel function, it is not clear what the benefit is overall.

Heemskerk SC, Dirksen CD, van Kuijk SMJ, Benninga MA, Baeten C, Masclee AAM et al.

Ann Surg 2024; 279: 746-754.

Sacral neuromodulation improved the number of patients able to defaecate on average at least three times a week (53.5 versus 3.8 per cent in controls, P=0.003), and improved their quality of life (P<0.001),  in this study that included 67 patients followed for six months.

Comment: Promising, minimally invasive treatment.

Ozcan C, Colak T, Turkmenoglu O, Berkesoglu M, Ertas E.

Br J Surg 2024; 111: znae189.

Use of the small bite technique reduced the rate of surgical site infection (18 versus 31 per cent, P=0.03) and the incisional hernia rate after two years (9 versus 31 per cent, P<0.001).

Comment: Small bites strongly recommended.