The impact of bowel preparation on anastomotic complications after laparoscopic colorectal resection: A prospective comparative study between oral polyethylene glycol and phosphate enema

Se-Jin Baek, Jin Choi Dong, Jin Kim, Uk Woo Si, Byung Wook Min, Seon Hahn Kim, Young Moon Hong

Research output: Contribution to journalArticle

Abstract

Purpose: Although most randomized trials demonstrated no advantage of mechanical bowel preparation for colorectal resection, an oral solution is still widely used. The aims of this study were to evaluate whether a single phosphate enema is as effective as oral polyethylene glycol (PEG) solution in preventing anastomotic complications after laparoscopic colorectal surgery and to examine the clinical courses of anastomotic complications. Methods: Between September 2006 and December 2007, 309 patients underwent laparoscopic colorectal resection with primary anastomosis. The bowel preparation used was PEG solution during initial period (PEG group), but since February 2007, a single phosphate enema (enema group) was utilized. Postoperative data were prospectively recorded. In patients with anastomotic complications, the clinical course was compared between the two groups. Results: There were 150 patients in the PEG group and 159 patients in the enema group. Demographics did not differ between the two groups. Anastomotic leakage occurred in 3.3 percent of the patients in the PEG group and 5.7 percent of the patients in the enema group (P=0.326). The rates of anastomotic bleeding were 2.0 and 2.5 percent, respectively (P=0.761). The hospital stays for patients with anastomotic complication were not different between the two groups (P=0.137), but patients in the PEG group (80%) needed reoperation more frequently than those in the enema group (11.1%) (P=0.023). Conclusion: These results suggest that laparoscopic colorectal surgery may be safely performed with a single phosphate enema instead of oral polyethylene glycol.

Original languageEnglish
Pages (from-to)294-299
Number of pages6
JournalJournal of the Korean Society of Coloproctology
Volume25
Issue number5
DOIs
Publication statusPublished - 2009 Oct 1

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Enema
Phosphates
Prospective Studies
Colorectal Surgery
Laparoscopy
Anastomotic Leak
Reoperation
Length of Stay
Demography
Hemorrhage

Keywords

  • Colorectal surgery
  • Laparoscopic surgery
  • Mechanical bowel preparation

ASJC Scopus subject areas

  • Gastroenterology

Cite this

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title = "The impact of bowel preparation on anastomotic complications after laparoscopic colorectal resection: A prospective comparative study between oral polyethylene glycol and phosphate enema",
abstract = "Purpose: Although most randomized trials demonstrated no advantage of mechanical bowel preparation for colorectal resection, an oral solution is still widely used. The aims of this study were to evaluate whether a single phosphate enema is as effective as oral polyethylene glycol (PEG) solution in preventing anastomotic complications after laparoscopic colorectal surgery and to examine the clinical courses of anastomotic complications. Methods: Between September 2006 and December 2007, 309 patients underwent laparoscopic colorectal resection with primary anastomosis. The bowel preparation used was PEG solution during initial period (PEG group), but since February 2007, a single phosphate enema (enema group) was utilized. Postoperative data were prospectively recorded. In patients with anastomotic complications, the clinical course was compared between the two groups. Results: There were 150 patients in the PEG group and 159 patients in the enema group. Demographics did not differ between the two groups. Anastomotic leakage occurred in 3.3 percent of the patients in the PEG group and 5.7 percent of the patients in the enema group (P=0.326). The rates of anastomotic bleeding were 2.0 and 2.5 percent, respectively (P=0.761). The hospital stays for patients with anastomotic complication were not different between the two groups (P=0.137), but patients in the PEG group (80{\%}) needed reoperation more frequently than those in the enema group (11.1{\%}) (P=0.023). Conclusion: These results suggest that laparoscopic colorectal surgery may be safely performed with a single phosphate enema instead of oral polyethylene glycol.",
keywords = "Colorectal surgery, Laparoscopic surgery, Mechanical bowel preparation",
author = "Se-Jin Baek and Dong, {Jin Choi} and Jin Kim and Si, {Uk Woo} and Min, {Byung Wook} and Kim, {Seon Hahn} and Hong, {Young Moon}",
year = "2009",
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T1 - The impact of bowel preparation on anastomotic complications after laparoscopic colorectal resection

T2 - A prospective comparative study between oral polyethylene glycol and phosphate enema

AU - Baek, Se-Jin

AU - Dong, Jin Choi

AU - Kim, Jin

AU - Si, Uk Woo

AU - Min, Byung Wook

AU - Kim, Seon Hahn

AU - Hong, Young Moon

PY - 2009/10/1

Y1 - 2009/10/1

N2 - Purpose: Although most randomized trials demonstrated no advantage of mechanical bowel preparation for colorectal resection, an oral solution is still widely used. The aims of this study were to evaluate whether a single phosphate enema is as effective as oral polyethylene glycol (PEG) solution in preventing anastomotic complications after laparoscopic colorectal surgery and to examine the clinical courses of anastomotic complications. Methods: Between September 2006 and December 2007, 309 patients underwent laparoscopic colorectal resection with primary anastomosis. The bowel preparation used was PEG solution during initial period (PEG group), but since February 2007, a single phosphate enema (enema group) was utilized. Postoperative data were prospectively recorded. In patients with anastomotic complications, the clinical course was compared between the two groups. Results: There were 150 patients in the PEG group and 159 patients in the enema group. Demographics did not differ between the two groups. Anastomotic leakage occurred in 3.3 percent of the patients in the PEG group and 5.7 percent of the patients in the enema group (P=0.326). The rates of anastomotic bleeding were 2.0 and 2.5 percent, respectively (P=0.761). The hospital stays for patients with anastomotic complication were not different between the two groups (P=0.137), but patients in the PEG group (80%) needed reoperation more frequently than those in the enema group (11.1%) (P=0.023). Conclusion: These results suggest that laparoscopic colorectal surgery may be safely performed with a single phosphate enema instead of oral polyethylene glycol.

AB - Purpose: Although most randomized trials demonstrated no advantage of mechanical bowel preparation for colorectal resection, an oral solution is still widely used. The aims of this study were to evaluate whether a single phosphate enema is as effective as oral polyethylene glycol (PEG) solution in preventing anastomotic complications after laparoscopic colorectal surgery and to examine the clinical courses of anastomotic complications. Methods: Between September 2006 and December 2007, 309 patients underwent laparoscopic colorectal resection with primary anastomosis. The bowel preparation used was PEG solution during initial period (PEG group), but since February 2007, a single phosphate enema (enema group) was utilized. Postoperative data were prospectively recorded. In patients with anastomotic complications, the clinical course was compared between the two groups. Results: There were 150 patients in the PEG group and 159 patients in the enema group. Demographics did not differ between the two groups. Anastomotic leakage occurred in 3.3 percent of the patients in the PEG group and 5.7 percent of the patients in the enema group (P=0.326). The rates of anastomotic bleeding were 2.0 and 2.5 percent, respectively (P=0.761). The hospital stays for patients with anastomotic complication were not different between the two groups (P=0.137), but patients in the PEG group (80%) needed reoperation more frequently than those in the enema group (11.1%) (P=0.023). Conclusion: These results suggest that laparoscopic colorectal surgery may be safely performed with a single phosphate enema instead of oral polyethylene glycol.

KW - Colorectal surgery

KW - Laparoscopic surgery

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