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An Open-Label Prospective Randomized Controlled Trial of Mechanical Bowel Preparation vs Nonmechanical Bowel Preparation in Elective Colorectal Surgery: Personal Experience

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Abstract

Over the last two decades, preoperative mechanical bowel preparation for elective colorectal surgery has been criticized. Yet, many surgeons are still in favor of its use simply because of the belief that it achieves better clearance of the colonic fecal load. The objective of this study is to compare the outcome with regard to patient compliance and postoperative complications following elective colorectal surgery between two groups of patients, one with bowel prepared mechanically and the other by nonmechanical means. This open-label prospective randomized controlled trial was conducted in a high-volume tertiary government referral hospital of Kolkata over a period of 3 years. It included 71 patients, divided into two groups, admitted for elective colorectal resection procedures in one surgical unit. Both methods of bowel preparation were equally well tolerated, and there was no statistically significant difference in the incidence of postoperative complications or mortality between the two groups.

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References

  1. Nichols RL, Condon RE (1971) Preoperative preparation of the colon. Surg Gynecol Obstet 2:323–337

    Google Scholar 

  2. Graney MJ, Graney CM (1980) Colorectal surgery from antiquity to the modern era. Dis Colon Rectum 23:432–441

    Article  CAS  PubMed  Google Scholar 

  3. Hughes ESR (1972) Asepsis in large-bowel surgery. Ann R Coll Surg Engl 51:347–356

    CAS  PubMed  PubMed Central  Google Scholar 

  4. Brownson P, Jenkins S, Nott D et al (1992) MBP before colorectal surgery: results of prospective randomized trial. Br J Surg 79:461–462

    Google Scholar 

  5. Bucher P, Gervaz P, Soravia C, Mermillod B, Erne M, Morel P (2005) Randomized clinical trial of mechanical bowel preparation versus no preparation before elective left-sided colorectal surgery. Br J Surg 92(4):409–414

    Article  CAS  PubMed  Google Scholar 

  6. Bucher P, Mermillod B, Gervaz P, Morel P (2004) Mechanical bowel preparation for elective colorectal surgery: a meta-analysis. Arch Surg 139(12):1359–1364, discussion 65

    Article  PubMed  Google Scholar 

  7. Wille-Jorgensen P, Guenaga KF, Matos D, Castro AA (2005) Preoperative mechanical bowel cleansing or not? An updated meta-analysis. Colorectal Dis 7(4):304–310

    Article  CAS  PubMed  Google Scholar 

  8. Vlot EA, Zeebregts CJ, Gerritsen JJ, Mulder HJ, Mastboom WJ, Klaase JM (2005) Anterior resection of rectal cancer without bowel preparation and diverting stoma. Surg Today 35(8):629–633

    Article  PubMed  Google Scholar 

  9. Slim K, Vicaut E, Panis Y, Chipponi J (2004) Meta-analysis of randomized clinical trials of colorectal surgery with or without mechanical bowel preparation. Br J Surg 91(9):1125–1130

    Article  CAS  PubMed  Google Scholar 

  10. Andrews L (2005) Review: bowel preparation before elective colorectal surgery increases anastomotic leakage more than no preparation. Evid Based Nurs 8(3):85

    Article  PubMed  Google Scholar 

  11. Jung B, Pahlman L, Nystrom PO, Nilsson E (2007) Multicentre randomized clinical trial of mechanical bowel preparation in elective colonic resection. Br J Surg 94(6):689–695

    Article  CAS  PubMed  Google Scholar 

  12. Contant CME, Hop WCJ, Van’t Sant HP, Oostvogel HJ, Smeets HJ, Stassen LPJ et al (2007) Mechanical bowel preparation for elective colorectal surgery: a multicentre randomised trial. Lancet 370:2112–2117

    Article  PubMed  Google Scholar 

  13. Guenaga KF, Matos D, Wille-Jorgensen P (2009) Mechanical bowel preparation for elective colorectal surgery. Cochrane Database Syst Rev 1, CD001544

    PubMed  Google Scholar 

  14. Holte K, Nielsen KG, Madsen JL, Kehlet H (2004) Physiologic effects of bowel preparation. Dis Colon Rectum 47:1397–1402

    Article  PubMed  Google Scholar 

  15. Jacob M, Chappell D, Rehm M (2007) Clinical update: perioperative fluid management. Lancet 369:1984–1986

    Article  PubMed  Google Scholar 

  16. Zmora O, Pikarsky AJ, Wexner SD (2001) Bowel preparation for colorectal surgery. Dis Colon Rectum 44:1537–1549

    Article  CAS  PubMed  Google Scholar 

  17. Van’t Sant HP, Weidema WF, Hop WCJ, Oostvogel HJM, Contant CME (2010) The influence of mechanical bowel preparation in elective lower colorectal surgery. Ann Surg 251:59–63

    Article  Google Scholar 

  18. Cao F, Li J, Li F (2012) Mechanical bowel preparation in elective colorectal surgery: updated systematic review and metaanalysis. Int J Colorectal Dis 6:803–810

    Article  Google Scholar 

  19. Zhu QD, Zhang QY, Zeng QQ, Yu ZP, Tao CL, Yang WJ (2010) Efficacy of mechanical bowel preparation with polyethylene glycol in prevention of postoperative complications in elective colorectal surgery: a meta-analysis. Int J Colorectal Dis 25:267–275

    Article  PubMed  Google Scholar 

  20. Slim K, Vicaut E, Launay-Savary MV, Contant CME, Chipponi J (2009) Updated systematic reviews and meta-analysis of randomized clinical trials on the role of mechanical bowel preparation before colorectal surgery. Ann Surg 249:203–209

    Article  PubMed  Google Scholar 

  21. Pitot D, Bouazza E, Chamlou R, Van de Stadt J (2009) Elective colorectal surgery without bowel preparation: a historical control and case-matched study. Acta Chir Belg 109(1):52–55

    CAS  PubMed  Google Scholar 

  22. Bretagnol F, Alves A, Ricci A, Valleur P, Panis Y (2007) Rectal cancer surgery without mechanical bowel preparation. Br J Surg 94(10):1266–1271

    Article  CAS  PubMed  Google Scholar 

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Correspondence to Prosanta Kumar Bhattacharjee.

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Bhattacharjee, P.K., Chakraborty, S. An Open-Label Prospective Randomized Controlled Trial of Mechanical Bowel Preparation vs Nonmechanical Bowel Preparation in Elective Colorectal Surgery: Personal Experience. Indian J Surg 77 (Suppl 3), 1233–1236 (2015). https://doi.org/10.1007/s12262-015-1262-3

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  • DOI: https://doi.org/10.1007/s12262-015-1262-3

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