Preoperative mechanical large bowel preparation in colorectal cancer surgery
https://doi.org/10.51523/2708-6011.2021-18-2-4
Abstract
Objective: to analyze literature data on the effectiveness of preoperative mechanical bowel preparation (MBP), and on the basis of our own data to perform a comparative analysis of immediate MBP results in patients operated on right-sided colon cancer.
Materials and methods. We reviewed literature data relevant to the use of MBP and performed a retrospective analysis of the immediate results of surgical interventions on right-sided colon cancer in 349 patients having undergone MBP with polyethylene glycol (PEG) compounds (n = 186) and without the use of PEG (n = 163).
Results. The incidence rates of complications in the patients of groups I and II were 6.7 % and 9.8 % (P>0.05), anastomotic leak rates were 0.6 % and 1.6 % (P>0.05), postoperative death rates — 1.2 % and 1.6 % (P>0.05), the average durations of the postoperative period were 14.9 and 12.1 days, respectively (P>0.05).
Conclusion. The use of preoperative MBP with PEG compounds does not result in enhancing the immediate results of the surgical treatment of patients with right-sided cancer.
About the Authors
A. P. Dyatlov
Gomel State Medical University; Gomel Regional Clinical Oncology Center
Belarus
Belarus
Alexandr P. Dyatlov, Assistant Lecturer at the Department of Oncology, Gomel State Medical University; surgical oncologist at the Abdominal Oncology Ward of Gomel Regional Clinical Oncology Center
Gomel
I. V. Mikhailov
Gomel State Medical University
Belarus
Belarus
Igor` V. Mikhailov, PhD (Med), Associate Professor, Head of the Department of Oncology
Gomel
V. A. Kudryashov
Gomel Regional Clinical Oncology Center
Belarus
Belarus
Vadim A. Kudryashov, Head of the Abdominal Oncology Ward
Gomel
K. A. Gned`ko
Gomel State Medical University
Belarus
Belarus
Kseniya A. Gned`ko, six-year student
Gomel
References
1. McKenna T, Macgill A, Porat G, Friedenberg FK. Colonoscopy preparation: polyethylene glycol with Gatorade is as safe and efficacious as four liters of polyethylene glycol with balanced electrolytes. Dig Dis Sci. 2012;57(12):3098– 3105. https://doi.org/10.1007/s10620-012-2266-5
2. Platell C, Barwood N, Makin G. Randomized clinical trial of bowel preparation with a single phosphate enema or polyethylene glycol before elective colorectal surgery. Br J Surg. 2006;93(4):427–433. https://doi.org/10.1002/bjs.5274
3. Bretangol F. Rectal cancer surgery with or without bowel preparation. Annals of Surgery. 2010;252(5):863– 868. https://doi.org/1097/SLA.0b013e3181fd8ea9
4. Baja J, Thakur DS, Sharma DB, Sharma D. Evaluation of primary anastomosis in prepared/unprepared colo-rectal surgeries, and correlation with physiological and operative severity score for the enumeration of mortality and morbidity scoring. Int Surg J. 2016 Aug;3(3):1364–1367. http://dx.doi.org/10.18203/2349-2902.isj20162712
5. Yamada T. Dysmotility by mechanical bowel preparation using polyethylene glycol. J. of Surgical Research. 2014;191(1):84–90. https://doi.org/10.1016/j.jss.2014.03.001
6. Bucher, P. Morphologic alteration associated with mechanical bowel preparation before elective colorectal surgery: a randomized trial. Dis Colon Rectum. 2006;49(1):109–112. https://doi.org/10.1007/s10350-005-0215-5
7. Pittet O. Rectal enema is an alternative to full mechanical bowel preparation for primary rectal cancer surgery. Colorectal Disease J. 2015;17(1):1007–1010. https://doi.org/10.1111/codi.12974
8. Bertani E, Chiappa A, Biffi R, Bianchi PP, Radice D, Branchi V, Spampatti S, Vetrano I, Andreoni B. Comparison of oral polyethylene glycol plus a large volume glycerine enema with a large volume glycerine enema alone in patients undergoing colorectal surgery for malignancy: a randomized clinical trial. Colorectal Dis. 2011;13(10):327– 334. https://doi.org/10.1111/j.1463-1318.2011.02689
9. van’tSant HP, Weidema WF, Hop WC, Lange JF, Contant CM. Evaluation of morbidity and mortality after anastomotic leakage following elective colorectal surgery in patients treated with or without mechanical bowel preparation. Am J Surg. 2011;202(3):321–324. https://doi.org/10.1016/j.amjsurg.2010.10.018
10. Bhat AH, Mir GH, Bhat SA, Ali M. Hospital based randomized prospective study outcomes in colorectal surgery after bowel preparation. Int Surg J. 2020;7(4):1191– 1194. https://doi.org/10.18203/2349-2902.isj20201395
11. Howard DD, White CQ, Harden TR, Ellis CN. Incidence of surgical site infections postcolorectal resections without preoperative mechanical or antibiotic bowel preparation. Am Surg. 2009;75(8):659–664. https://doi.org/10.1055/s-0033-1351129
12. Güenaga KF, Matos D, Wille-Jorgensen P. Mechanical bowel preparation for elective colorectal surgery. Cochrane Database Syst Rev. 2011 Sep 7;2011(9):CD001544. https://doi.org/10.1002/14651858.CD001544.pub4
13. Sasaki J, Matsumoto S, Kan H, Yamada T, Koizumi M, Mizuguchi Y, Uchida E. Objective assessment of postoperative gastrointestinal motility in elective colonic resection using a radiopaque marker provides an evidence for the abandonment of preoperative mechanical bowel preparation. Journal of Nippon Medical School. 2012;79(4):259–266. https://doi.org/10.1272/jnms.79.259
14. Hu Yj, Li K, Li L, Wang XD, Yang J, Feng JH, Zhang W, iu YW Early outcomes of elective surgery for colon cancer with preoperative mechanical bowel preparation: a randomized clinical trial. Journal of Southern Medical University. 2017;37(1):13–17. https://doi.org/10.3969/j.issn.1673-4254.2017.01.03
15. Slim K., Martin G. Mechanical bowel preparation before colorectal surgery. Where do we stand? Journal de Chirurgie Viscérale. 2015;153(2):87–89. https://doi.org/10.1016/j.jchirv.2015.09.015
16. Mtvralashvili DA, Veselov VV, Galjaev AV. Opyt primenenija preparatov polijetilenglikolja dlja podgotovki k jendoskopicheskim issledovanijam i vmeshatel’stvam. Lechebnoe Delo. 2016(3):85. (In Russ.). https://cyberleninka.ru/article/n/opyt-primeneniya-preparatov-polietilenglikolya-dlya-podgotovki-k-endoskopicheskimissledovaniyam-i-vmeshatelstvam
17. Wexner SD, Beck DE, Baron TH, Fanelli RD, Hyman N, Shen B, Wasco KE; American Society of Colon and Rectal Surgeons; American Society for Gastrointestinal Endoscopy; Society of American Gastrointestinal and Endoscopic Surgeons. A consensus document on bowel preparation before colonoscopy: prepared by a task force from the American Society of Colon and Rectal Surgeons (ASCRS), the American Society for Gastrointestinal Endoscopy (ASGE), and the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES). Gastrointestinalendoscopy. 2006;63(7):894-909. https://doi.org/10.1016/j.gie.2006.03.918
18. Kim YW, Choi EH, Kim IY, Kwon HJ, Ahn SK. The Impact of Mechanical Bowel Preparation in Elective Colorectal Surgery: A Propensity Score Matching Analysis. Yonsei Med J. 2014;55(5):1273–1280. https://doi.org/10.3349/ymj.2014.55.5.1273W
19. Kahokehr A, Robertson P, Sammour T, Soop M, Hill AG. Perioperative care: a survey of New Zealand and Australian colorectal surgeons. Colorectal disease. 2011 Nov;(13)11:1308–1313. https://doi.org/10.1111/j.1463-1318.2010.02453.x
20. Kiran RP, Murray AC, Chiuzan C, Estrada D, Forde K. Combined Preoperative Mechanical Bowel Preparation With Oral Antibiotics Significantly Reduces Surgical Site Infection, Anastomotic Leak, and Ileus After Colorectal Surgery. Annals of Surgery J. 2015;262(3):416– 425. https://doi.org/10.1097/SLA.0000000000001416
Review
For citations:
Dyatlov A.P., Mikhailov I.V., Kudryashov V.A., Gned`ko K.A. Preoperative mechanical large bowel preparation in colorectal cancer surgery. Health and Ecology Issues. 2021;18(2):25-32. (In Russ.) https://doi.org/10.51523/2708-6011.2021-18-2-4
Views: 430
Email this article 