Abstract
PURPOSE: This study was undertaken to determine whether a mechanical bowel preparation with 2 liters of polyethylene glycol solution combined with a laxative (Group A) increases the acceptability of bowel preparation and reduces discomfort compared with 4 liters of polyethylene glycol solution (Group B). METHODS: One hundred patients undergoing an elective colorectal resection were included in a prospective, randomized study. Acceptability (nausea, vomiting, abdominal cramps, discomfort from insertion of the nasogastric tube, and anal discomfort) was assessed using visual analog scales. Efficacy of bowel lavage was scored intraoperatively by a blinded surgeon. RESULTS: Overall acceptability was 5.1±2.8 in Group A patients and 5.6±2.6 in Group B patients ( P =0.5). The incidence and visual analog score for nausea, vomiting, anal discomfort, and cramps were not different between groups. Excellent efficacy of bowel preparation was shown in 94 percent of patients in Group A and 84 percent of patients in Group B ( P =0.5). The incidence of septic complications was 2 percent in Group A patients and 12 percent in Group B patients ( P =0.06). CONCLUSION: Because the acceptability of both cleansing regimens were not different, 2 liters of polyethylene glycol plus Prepacol ® should be preferred because the amount of fluid administered to clean the bowel is reduced and the nasogastric tube can always be avoided.
Similar content being viewed by others
References
Hewitt J, Reeve J, Rigby J, Cox AG. Whole-gut irrigation in preparation for large-bowel surgery. Lancet 1973;2:337–40.
Hares MM, Alexander-Williams J. The effect of bowel preparation on colonic surgery. World J Surg 1982;6:175–81.
Keighley MR, Arabi Y, Alexander-Williams J, Youngs D, Burdon DW. Comparison between systemic and oral antimicrobial prophylaxis in colorectal surgury. Lancet 1979;1:894–7.
Irving AD, Scrimgeour D. Mechanical bowel preparation for colonic resection and anastomosis. Br J Surg 1987;74:580–1.
Wolters U, Keller HW, Sorgatz S, Raab A, Pichlmaier H. Prospective randomized study of preoperative bowel cleansing for patients undergoing colorectal surgery. Br J Surg 1994;81:598–600.
Vilien M, Rytkonen M. Golytely preparation for colonoscopy: 1.5 liters is enough for outpatients. Endoscopy 1990;22:168–70.
Fleites RA, Marshall JB, Eckhauser ML, Mansour EG, Imbembo AL, Cullough AJ. The efficacy of polyethylene glycol-electrolyte lavage solution versus traditional mechanical bowel preparation for elective colonic surgury: a randomized, prospective, blinded clinical trial. Surgery 1985;98:708–17.
Davis GR, Santa Ana CA, Morawski SG. Development of a lavage solution associated with minimal water and electrolyte absorption or secretion. Gastroenterology 1980;78:991–5.
Fordtran JS, Santa Ana CA, Cleveland MB. A lowsodium solution for gastrointestinal lavage. Gastroenterology 1990;98:11–6.
Goldberg PA, Madden MV, Wright JP, Powell B, Abrahams S, van Schaik DF. A study of new osmotic purgative for colonoscopy. Surg Endosc 1995;9:329–31.
Downing R, Dorricott NJ, Keighley MR, Oates GD, Alexander-Williams J. Whole gut irrigation: a survey of patient opinion. Br J Surg 1979;66:201–2.
Köhler L, Vestweber KH, Mennigen R, Sommer H, Troidl H. Whole gut irrigation and Prepacol laxative preparation for colonoscopy: a comparison. Br J Surg 1990;77:527–9.
Adams WJ, Meagher AP, Lubowski DZ, King DW. Bisacodyl reduces the volume of polyethylene glycol solution required for bowel preparation. Dis Colon Rectum 1994;37:229–34.
Author information
Authors and Affiliations
About this article
Cite this article
Gründel, K., Schwenk, W., Böhm, B. et al. Improvements in mechanical bowel preparation for elective colorectal surgery. Dis Colon Rectum 40, 1348–1352 (1997). https://doi.org/10.1007/BF02050821
Issue Date:
DOI: https://doi.org/10.1007/BF02050821