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The effect of mechanical bowel preparation on postoperative complications in laparoscopic right colectomy: a retrospective propensity score matching analysis

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Abstract

Purpose

To assess whether full bowel preparation affects 30-day surgical outcomes in laparoscopic right colectomy for colon cancer.

Methods

A retrospective chart review of all elective laparoscopic right colectomies performed for colonic adenocarcinoma between Jan 2011 and Dec 2021. The cohort was divided into two groups—no bowel preparation (NP) group and patients who received full bowel preparation (FP), including oral and mechanical cathartic bowel preparation. All anastomoses were extracorporeal stapled side-to-side. The two groups were compared at baseline and then were matched using propensity score based on demographic and clinical parameters. The primary outcome was 30-day postoperative complication rate, mainly anastomotic leak (AL) and surgical site infection (SSI) rate.

Results

The original cohort included 238 patients with a median age of 68 (SD 13) and equal M:F ratio. Following propensity score matching, 93 matched patients were included in each group. Analysis of the matched cohort showed a significantly higher overall complication rate in the FP group (28 vs 11.8%, p = 0.005) which was mostly due to minor type II complications. There were no differences in major complication rates, SSI, ileus, or AL rate. Although operative time was significantly longer in the FP group (119 vs 100 min, p ≤ 0.001), length of stay was significantly shorter in the FP group (5 vs 6 days, p = 0.001).

Conclusions

Aside from a shorter hospital stay, full mechanical bowel preparation for laparoscopic right colectomy does not seem to have any benefit and may be associated with a higher overall complication rate.

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Data availability

The authors confirm that the data supporting the findings of this study are available from the corresponding author, upon reasonable request.

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Authors and Affiliations

  1. Department of General Surgery, Shaare Zedek Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel

    Michal Perets, Shlomo Yellinek, Ofra Carmel, Elad Boaz, Amir Dagan, Petachia Reissman & Michael R. Freund

  2. Department of Surgery and Transplantations, Sheba Medical Center, Ramat Gan, Affiliated with the Faculty of Medicine, Tel Aviv University, Tel Hashomer, Israel

    Nir Horesh

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  1. Michal Perets
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Contributions

Michal Perets, Shlomo Yellinek, Michael R. Freund, and Petachia Reissman: Conception and design of the study. Michal Perets and Michael R. Freund: IRB approval. Michal Perets and Ofra Carmel: Data collection. Michael R. Freund and Nir Horesh: Statistical analysis and propensity matching. Michal Perets and Michael R. Freund: Wrote the manuscript, text, and tables. Michal Perets, Shlomo Yellinek, Ofra Carmel, Elad Boaz, Amir Dagan, Nir Horesh, Petachia Reissman, and Michael R. Freund reviewed and edited the manuscript.

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Correspondence to Michal Perets.

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Perets, M., Yellinek, S., Carmel, O. et al. The effect of mechanical bowel preparation on postoperative complications in laparoscopic right colectomy: a retrospective propensity score matching analysis. Int J Colorectal Dis 38, 133 (2023). https://doi.org/10.1007/s00384-023-04409-6

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