BACKGROUND: Mechanical bowel preparation (MBP) before elective open colon resection does not reduce the rate of postoperative anastomotic leakage. However, MBP is still routinely used in many countries, and there are very limited data regarding the utility of preoperative MBP in patients undergoing laparoscopic colon resection (LCR). The aim of this study was to challenge the use of MBP before elective LCR. METHODS: It is a retrospective analysis of a prospectively collected database. All patients undergoing elective LCR with primary anastomosis and no stoma were included. Preoperative MBP with polyethylene glycol solution was used routinely between April 1992 and December 2004, and then it was abandoned. The early postoperative outcomes in patients who had preoperative MBP (MBP group) and in patients who underwent LCR without preoperative MBP (No-MBP group) were compared. RESULTS: From April 1992 to December 2014, 1535 patients underwent LCR: 706 MBP patients and 829 No-MBP patients. There were no differences in demographic data, indication for surgery and type of procedure performed between MBP and No-MBP group patients. The incidence of anastomotic leakage was similar between the two groups (3.4 vs. 3.6 %, p = 0.925). No differences were observed in intra-abdominal abscesses (0.6 vs. 0.8 %, p = 0.734), wound infections (0.6 vs. 1.4 %, p = 0.149), infectious extra-abdominal complications (1.8 vs. 3 %, p = 0.190), and non-infectious complications (6.1 vs. 6.8 %, p = 0.672). The overall reoperation rate was 4.6 % for MBP patients and 5 % for No-MBP patients (p = 0.813). CONCLUSION: The use of preoperative MBP does not seem to be associated with lower incidence of intra-abdominal septic complications after LCR.
BACKGROUND:Mechanical bowel preparation (MBP) before elective open colon resection does not reduce the rate of postoperative anastomotic leakage. However, MBP is still routinely used in many countries, and there are very limited data regarding the utility of preoperative MBP in patients undergoing laparoscopic colon resection (LCR). The aim of this study was to challenge the use of MBP before elective LCR. METHODS: It is a retrospective analysis of a prospectively collected database. All patients undergoing elective LCR with primary anastomosis and no stoma were included. Preoperative MBP with polyethylene glycol solution was used routinely between April 1992 and December 2004, and then it was abandoned. The early postoperative outcomes in patients who had preoperative MBP (MBP group) and in patients who underwent LCR without preoperative MBP (No-MBP group) were compared. RESULTS: From April 1992 to December 2014, 1535 patients underwent LCR: 706 MBPpatients and 829 No-MBPpatients. There were no differences in demographic data, indication for surgery and type of procedure performed between MBP and No-MBP group patients. The incidence of anastomotic leakage was similar between the two groups (3.4 vs. 3.6 %, p = 0.925). No differences were observed in intra-abdominal abscesses (0.6 vs. 0.8 %, p = 0.734), wound infections (0.6 vs. 1.4 %, p = 0.149), infectious extra-abdominal complications (1.8 vs. 3 %, p = 0.190), and non-infectious complications (6.1 vs. 6.8 %, p = 0.672). The overall reoperation rate was 4.6 % for MBPpatients and 5 % for No-MBPpatients (p = 0.813). CONCLUSION: The use of preoperative MBP does not seem to be associated with lower incidence of intra-abdominal septic complications after LCR.
Authors: Marc Zerey; Lisa Martin Hawver; Ziad Awad; Dimitrios Stefanidis; William Richardson; Robert D Fanelli Journal: Surg Endosc Date: 2012-12-13 Impact factor: 4.584
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Authors: Caroline M E Contant; Wim C J Hop; Hans Pieter van't Sant; Henk J M Oostvogel; Harm J Smeets; Laurents P S Stassen; Peter A Neijenhuis; Floris J Idenburg; Cees M Dijkhuis; Piet Heres; Willem F van Tets; Jos J G M Gerritsen; Wibo F Weidema Journal: Lancet Date: 2007-12-22 Impact factor: 79.321
Authors: Stavros A Antoniou; Sofia Tsokani; Dimitrios Mavridis; Ferdinando Agresta; Manuel López-Cano; Filip E Muysoms; Salvador Morales-Conde; Hendrik-Jaap Bonjer; Thérèse van Veldhoven; Nader K Francis Journal: Surg Endosc Date: 2020-04-02 Impact factor: 4.584