Mechanical bowel preparation before elective colorectal surgery: Is it necessary? A prospective, randomized and controlled study
PDF
Cite
Share
Request
Original Article
VOLUME: 28 ISSUE: 2
P: 84 - 87
June 2012

Mechanical bowel preparation before elective colorectal surgery: Is it necessary? A prospective, randomized and controlled study

Turk J Surg 2012;28(2):84-87
1. Elazığ Eğitim ve Araştırma Hastanesi, Genel Cerrahi, Elazığ, Türkiye
2. Adana Numune Eğitim ve Araştırma Hastanesi, Genel Cerrahi, Adana, Türkiye
No information available.
No information available
PDF
Cite
Share
Request

Abstract

Objective: The application of mechanical bowel preparation before colorectal surgery is a commonly used method among the colorectal surgeons. By this way, it is hoped to decrease the complications of colorectal surgery. In this study, we investigated the effects of bowel preparation on the complication rates of colorectal surgery. Methods: A total of 100 patients who had elective colorectal surgery between January 2006 and December 2011 were included in the study. The patients were divided into two groups randomly. The operations were performed without mechanical bowel preparation in Group 1, while mechanical bowel preparation was performed in Group 2 before surgery. The number of patients in Group 1 and 2 were nearly same, 53 and 47, respectively. Both groups were operated by the same surgical team and surgical technique. Postoperative complication rates were compared between the groups. Results: One anastomotic leakage and one intraabdominal abscess were observed in Group 1. There was no significant difference between the groups (p=0.288 and p=0.288). The time to first defecation was 3.2±0.9 days in Group 1 and 3.3±0.7 days in Group 2 after surgery. There was no significant difference between the groups (p=0.521). Conclusion: There was no difference on mortality or morbidity rates between the groups.

Keywords:
Mechanical bowel preparation, colorectal surgery, complications

References

1
Edwards DP. The history of colonic surgery in war. J R Army Med Corps 1999; 145:107–108.
2
Rosenberg IL, Graham NG, De Dombal et al. Preparation of the intestine in patients undergoing major large bowel surgery, mainly for neoplasms of the colon and rectum. Br J Surg 1971; 58:266–269. doi:10.1002/bjs.1800580408
3
Davis GR, Santa Ana CA, Morawski SG, et al. Development of a lavage solution associated with minimum water and electrolyte absorption or secretion. Gastroenterology 1980; 78:991–995.
4
Chan A, Depew W, Vanner S. Use of oral sodium phosphate colonic lavage solution by Canadian colonoscopists: pitfalls and complications. Can J Gastroenterol 1997; 11:334–338.
5
Hsu CW, Imperiale TF. Meta-analysis and cost comparison of polyethylene glycol lavage versus sodium phosphate for colonoscopy preparation. Gastrointest Endosc 1998; 48:276–282.
6
Mahajna A, Krausz M, Rosin D, et al. Bowel preparation is associated with spillage of bowel contents in colorectal surgery. Dis Colon Rectum 2005; 48:1626–1631. doi: 10.1007/ s10350-005-0073-1
7
Mayir B, Erdoğan O. Elektif kolorektal cerrahi öncesi mekanik barsak temizliği uygulanmalı mı? Kolon Rektum Hast Derg 2009; 19:102–105.
8
Zmora O, Wexner SD, Hajjar L et al. Trends in preparation for colorectal surgery: survey of the members of the American society of colon and rectal surgeons. Am Surg 2003; 69:150–154.
9
Eskicioğlu C, Forbes SS, Fenech DS, et al. Preoperative bowel preparation for patients undergoing elective colorectal surgery: a clinical practice guideline endorsed by the Canadian Society of Colon and Rectal Surgeons. Can J Surg 2010; 53:385–395.
10
Jung B, Pahlman L, Nyström PO, et al. Mechanical bowel preparation study group. Multicentre randomized clinical trial of mechanical bowel preparation in elective colonic resection. Br J Surg 2007; 94:689–695. doi: 10.1002/bjs.5816
11
Berg RD. Bacterial translocation from the gastrointestinal tract. Adv Exp Med Biol 1999; 473:11–30.
12
Gravante G, Caruso R, Andreani SM, et al. Mechanical bowel preparation for colorectal surgery: a meta-analysis on abdominal and systemic complications on almost 5.000 patient. Int J Colorectal Dis 2008; 23:1145–1150. doi:10.1007/ s00384-008-0592-z
13
Contant CM, Hop WC, Van't Sant HP, et al. Mechanical bowel preparation for colorectal surgery: a multicentre randomised trial. Lancet 2007; 22:2112–2117.
14
Bucher P, Gervaz P, Egger JF, et al. Morphologic alterations associated with mechanical bowel preparation for colorectal surgery: a randomized trial. Dis Colon Rectum 2006; 49:109–112. doi:10.1007/s10350-005-0215-5
15
Cao F, Li J, Li F. Mechanical bowel preparation for colorectal surgery: updated systematic review and meta-analysis. Int J Colorectal Dis 2011; published online. doi:10.1007/s00384-011-1361-y
16
Bretagnol F, Alves A, Ricci A, et al. Rectal cancer surgery without mechanical bowel preparation. Br J Surg 2007; 94:1266– 1271. doi: 10.1002/bjs.5524
17
Vlot EA, Zeebregts CJ, Gerritsen JJ, et al. Anterior resection of rectal cancer without bowel preparation and diverting stoma. Surg Today 2005; 35:629–633. doi:10.1007/s00595-005-2999-2
18
Jung B, Pahlman L, Nyström PO, Nisson E. Mechanical bowel preparation study group. Multicentre randomized clinical trial of mechanical bowel preparation in elective colonic resection. Br J Surg 2007; 94:689–695. doi: 10.1002/bjs.5816
19
Van Geldere D, Fa-Si-Oen P, Noach LA, et al. Complications after colorectal surgery without mechanical bowel preparation. J Am Coll Surg 2002; 194:40–47. doi:10.1016/S1072-7515(01)01131-0
20
Zmora O, Lebedyev A, Hoffman A, et al. Laparoscopic colectomy without mechanical bowel preparation. Int J Colorectal Dis 2006; 21:683–687. doi:10.1007/s00384-005-0044-y
21
Lassen K, Hannemann P, Ljungqvist O, et al. Enhanced Recovery After Surgery Group. Patterns in current perioperative practice: survey of colorectal surgeons in five northern European countries. BMJ 2005; 330:1420–1421. doi: 10.1136/ bmj.38478.568067.AE
22
Roig JV, Garcia-Fadique A, Garcia- Armengol J, et al. Mechanical bowel preparation and antibiotic prophylaxis in colorectal surgery: use by and options of Spanish surgeons. Colorectal Dis 2009; 11:44–48. doi:10.1111/j.1463-1318.2008.01542.x
23
Hasenberg T, Keese M, Langle F, et al. ‘Fast-trak' colonic surgery in Austria and German results from the survey on patterns in current perioperative practice. Colorectal Dis 2009; 11:162–167. doi:10.1111/j.1463-1318.2008.01559.x