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Benign GI diease,Epidemiology & etiology
- A Review of Bowel Preparation Before Colorectal Surgery
- Yeon Uk Ju, Byung Wook Min
- Ann Coloproctol. 2021;37(2):75-84. Published online May 15, 2020
- DOI: https://doi.org/10.3393/ac.2020.04.01
- 8,474 View
- 284 Download
- 13 Web of Science
- 11 Citations
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Abstract
PDF - Infectious complications are the biggest problem during bowel surgery, and one of the approaches to minimize them is the bowel cleaning method. It was expected that bowel cleaning could facilitate bowel manipulation as well as prevent infectious complications and further reduce anastomotic leakage. In the past, with the development of antibiotics, bowel cleaning and oral antibiotics (OA) were used together. However, with the success of emergency surgery and Enhanced Recovery After Surgery, bowel cleaning was not routinely performed. Consequently, bowel cleaning using OA was gradually no longer used. Recently, there have been reports that only bowel cleaning is not helpful in reducing infectious complications such as surgical site infection (SSI) compared to OA and bowel cleaning. Accordingly, in order to reduce SSI, guidelines are changing the trend of only intestinal cleaning. However, a consistent regimen has not yet been established, and there is still controversy depending on the location of the lesion and the surgical method. Moreover, complications such as Clostridium difficile infection have not been clearly analyzed. In the present review, we considered the overall bowel preparation trends and identified the areas that require further research.
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Citations
Citations to this article as recorded by
- General Principles of Preoperative Risk Mitigation
Sarah Atoui, A. Sender Liberman
Clinics in Colon and Rectal Surgery.2025;[Epub] CrossRef - Feasibility of the ERAS (Enhanced Recovery After Surgery) Protocol in Patients Undergoing Gastrointestinal Cancer Surgeries in a Tertiary Care Hospital—A Prospective Interventional Study
Surya Theja, Seema Mishra, Sandeep Bhoriwal, Rakesh Garg, Sachidanand Jee Bharati, Vinod Kumar, Nishkarsh Gupta, Saurabh Vig, Sunil Kumar, S. V. S. Deo, Sushma Bhatnagar
Indian Journal of Surgical Oncology.2024; 15(2): 304. CrossRef - Influence of additional prophylactic oral antibiotics during mechanical bowel preparation on surgical site infection in patients receiving colorectal surgery
Hayoung Lee, Jong Lyul Lee, Ji Sung Lee, Chan Wook Kim, Yong Sik Yoon, In Ja Park, Seok‐Byung Lim
World Journal of Surgery.2024; 48(6): 1534. CrossRef - The Impact of Surgical Bowel Preparation on the Microbiome in Colon and Rectal Surgery
Lauren Weaver, Alexander Troester, Cyrus Jahansouz
Antibiotics.2024; 13(7): 580. CrossRef - Pre-Operative Mechanical Bowel Preparation Does Not Affect the Impact of Anastomosis Leakage in Left-Side Colorectal Surgery—A Single Center Observational Study
Ludovít Danihel, Marian Cerny, Ivor Dropco, Petra Zrnikova, Milan Schnorrer, Marek Smolar, Miloslav Misanik, Stefan Durdik
Life.2024; 14(9): 1092. CrossRef - Bowel cleansing, dysbiosis, and postoperative infection: the dots are starting to connect
John C Alverdy
British Journal of Surgery.2024;[Epub] CrossRef - A prospective, randomized assessment of a novel, local antibiotic releasing platform for the prevention of superficial and deep surgical site infections
O. Zmora, Y. Stark, O. Belotserkovsky, M. Reichert, G. A. Kozloski, N. Wasserberg, H. Tulchinsky, L. Segev, A. J. Senagore, N. Emanuel
Techniques in Coloproctology.2023; 27(3): 209. CrossRef - Bacterial Decontamination: Bowel Preparation and Chlorhexidine Bathing
Yadin Bornstein, Elizabeth C. Wick
Clinics in Colon and Rectal Surgery.2023; 36(03): 201. CrossRef - Effect of non-mechanical bowel preparation on postoperative gastrointestinal recovery following surgery on malignant gynecological tumors: A randomized controlled trial
Shan-shan Wang, Hong-yan Xu, Xing-xia Li, Su-wen Feng
European Journal of Oncology Nursing.2023; 64: 102320. CrossRef - The Latest Results and Future Directions of Research for Enhanced Recovery after Surgery in the Field of Colorectal Surgery
Min Ki Kim
The Ewha Medical Journal.2023;[Epub] CrossRef - The Impact of the Enhanced Recovery After Surgery (ERAS) Protocol on Colorectal Surgery in a Portuguese Tertiary Hospital
Catarina Lopes, Mariana Vaz Gomes, Manuel Rosete, Ana Almeida, Luisa Isabel Silva, José Guilherme Tralhão
Acta Médica Portuguesa.2022; 36(4): 254. CrossRef
- General Principles of Preoperative Risk Mitigation
Original Articles
- Mechanical Bowel Preparation and Prophylactic Antibiotic Administration in Colorectal Surgery: A Survey of the Current Status in Korea
- Byung Mo Kang, Kil Yeon Lee, Sun Jin Park, Suk-Hwan Lee
- Ann Coloproctol. 2013;29(4):160-166. Published online August 29, 2013
- DOI: https://doi.org/10.3393/ac.2013.29.4.160
- 4,877 View
- 48 Download
- 19 Citations
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Abstract
PDF
Purpose The usefulness of mechanical bowel preparation (MBP) in colon surgery was recently challenged by many multicenter clinical trials and meta-analyses. The objectives of this study were to investigate current national opinions about MBP and prophylactic antibiotics (PA) and to provide preliminary data for developing future Korean guidelines for MBP and PA administration in colorectal surgery.
Methods A questionnaire was mailed to 129 colorectal specialists. The questionnaires addressed the characteristics of the hospital, the MBP methods, and the uses of oral and intravenous antibiotics.
Results A total of 73 questionnaires (56.6%) were returned. First, in regard to MBP methods, most surgeons (97.3%) used MBP for a mean of 1.36 days. Most surgeons (98.6%) implemented whole bowel irrigation and used polyethylene glycol (83.3%). Oral antibiotic use was indicated in over half (52.1%) of the responses, the average number of preoperative doses was three, and the mean time of administration was 24.2 hours prior to the operation. Finally, the majority of responders stated that they used intravenous antibiotics (95.9%). The responses demonstrated that second-generation cephalosporin-based regimens were most commonly prescribed, and 75% of the surgeons administered these regimens until three days after the operation.
Conclusion The results indicate that most surgeons used MBP and intravenous antibiotics and that half of them administered oral PA in colorectal surgery preparations. The study recommends that the current Korean guidelines should be adapted to adequately reflect the medical status in Korea, to consider the medical environment of the various hospitals, and to establish more accurate and relevant guidelines.
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Citations
Citations to this article as recorded by- RETRACTED: A meta‐analysis of the risk factors for surgical site infection in patients with colorectal cancer
Yani Chen, Hua Guo, Tian Gao, Jiale Yu, Yujia Wang, Haiquan Yu
International Wound Journal.2024;[Epub] CrossRef - Surgical Site Infections in Colorectal Cancer Surgeries: A Systematic Review and Meta-Analysis of the Impact of Surgical Approach and Associated Risk Factors
Valentin Calu, Catalin Piriianu, Adrian Miron, Valentin Titus Grigorean
Life.2024; 14(7): 850. CrossRef - Uncovering the Function of MBP and Antibiotics in Preventing Surgical Site Infections during Colorectal Procedures
Agnes Sara Shibu, Rojin G. Raj, Rohit Singh Deo
Journal of Coloproctology.2024; 44(03): e209. CrossRef - Single-Dose Versus Multiple-Dose Prophylactic Antibiotics in Minimally Invasive Colorectal Surgery: A Propensity Score Matched Analysis
Ga Yoon Ku, Beom-jin Kim, Ji Won Park, Min Jung Kim, Seung-Bum Ryoo, Seung-Yong Jeong, Kyu Joo Park
Journal of Korean Medical Science.2024;[Epub] CrossRef - Preoperative mechanical bowel preparation using conventional versus hyperosmolar polyethylene glycol-electrolyte lavage solution before laparoscopic resection for colorectal cancer (TLUMP test): a phase III, multicenter randomized controlled non-inferiori
Tadashi Yoshida, Shigenori Homma, Nobuki Ichikawa, Yosuke Ohno, Yoichi Miyaoka, Hiroki Matsui, Ken Imaizumi, Hiroyuki Ishizu, Tohru Funakoshi, Masahiko Koike, Hirofumi Kon, Yo Kamiizumi, Yasuhiro Tani, Yoichi Minagawa Ito, Kazufumi Okada, Akinobu Taketomi
Journal of Gastroenterology.2023; 58(9): 883. CrossRef - The risk of surgical site infection of oral sulfate tablet versus sodium picosulfate for bowel preparation in colorectal cancer surgery: a randomized clinical trial
Sung Sil Park, Sung Chan Park, Dong-Eun Lee, Dong Woon Lee, Kiho Yu, Hyoung-Chul Park, Chang Won Hong, Dae Kyung Sohn, Kyung Su Han, Bun Kim, Byung Chang Kim, Jae Hwan Oh
Annals of Surgical Treatment and Research.2022; 103(2): 96. CrossRef - Preoperative Elemental Diet before Laparoscopic Anterior Resection in Patients with Advanced Stenotic Rectal Cancer
Tadashi Yoshida, Shigenori Homma, Nobuki Ichikawa, Hiroaki Iijima, Akinobu Taketomi
Journal of the Anus, Rectum and Colon.2021; 5(4): 395. CrossRef - Orale Antibiotikaprophylaxe zur Darmdekontamination vor elektiver kolorektaler Chirurgie
S. Flemming, C.-T. Germer
Der Chirurg.2020; 91(2): 128. CrossRef - Role of Mechanical Bowel Preparation for Elective Colorectal Surgery
Ik Yong Kim
The Korean Journal of Gastroenterology.2020; 75(2): 79. CrossRef - Update on risk factors of surgical site infection in colorectal cancer: a systematic review and meta-analysis
Zhaohui Xu, Hui Qu, George Kanani, Zhong Guo, Yanying Ren, Xin Chen
International Journal of Colorectal Disease.2020; 35(12): 2147. CrossRef - Does Mechanical Bowel Preparation Ameliorate Surgical Performance in Anterior Lumbar Interbody Fusion?
Chang-Hoon Jeon, Han-Dong Lee, Nam-Su Chung
Global Spine Journal.2019; 9(7): 692. CrossRef - Mechanical Bowel Preparation Does Not Affect Clinical Severity of Anastomotic Leakage in Rectal Cancer Surgery
Woong Bae Ji, Koo Yong Hahn, Jung Myun Kwak, Dong Woo Kang, Se Jin Baek, Jin Kim, Seon Hahn Kim
World Journal of Surgery.2017; 41(5): 1366. CrossRef - Comparing Mechanical Bowel Preparation With Both Oral and Systemic Antibiotics Versus Mechanical Bowel Preparation and Systemic Antibiotics Alone for the Prevention of Surgical Site Infection After Elective Colorectal Surgery
Min Chen, Xue Song, Liang-zhou Chen, Zhi-dong Lin, Xue-li Zhang
Diseases of the Colon & Rectum.2016; 59(1): 70. CrossRef - Early Outcomes of Endoscopic Submucosal Dissection for Colorectal Neoplasms According to Clinical Indications
Eui-Gon Youk, Dae Kyng Sohn, Chang Won Hong, Seong Dae Lee, Kyung Su Han, Byung Chang Kim, Hee Jin Chang, Mi-Jung Kim
Diseases of the Colon & Rectum.2016; 59(5): 403. CrossRef - Benefit of mechanical bowel preparation prior to elective colorectal surgery: current insights
A. C. A. Murray, R. P. Kiran
Langenbeck's Archives of Surgery.2016; 401(5): 573. CrossRef - Is mechanical bowel preparation still necessary for gynecologic laparoscopic surgery? A meta‐analysis
Huaping Huang, Haiyan Wang, Mei He
Asian Journal of Endoscopic Surgery.2015; 8(2): 171. CrossRef - Nationwide Analysis of Outcomes of Bowel Preparation in Colon Surgery
Zhobin Moghadamyeghaneh, Mark H. Hanna, Joseph C. Carmichael, Steven D. Mills, Alessio Pigazzi, Ninh T. Nguyen, Michael J. Stamos
Journal of the American College of Surgeons.2015; 220(5): 912. CrossRef - Influence of Shorter Duration of Prophylactic Antibiotic Use on the Incidence of Surgical Site Infection Following Colorectal Cancer Surgery
Youn Young Park, Chang Woo Kim, Sun Jin Park, Kil Yeon Lee, Jung Joo Lee, Hye Ok Lee, Suk-Hwan Lee
Annals of Coloproctology.2015; 31(6): 235. CrossRef - Mechanical Bowel Preparation: Keep It or Abandon It?
Hungdai Kim
Annals of Coloproctology.2013; 29(4): 136. CrossRef
- RETRACTED: A meta‐analysis of the risk factors for surgical site infection in patients with colorectal cancer
- The Impact of Bowel Preparation on Anastomotic Complications after Laparoscopic Colorectal Resection: A Prospective Comparative Study between Oral Polyethylene Glycol and Phosphate Enema.
- Baek, Se Jin , Choi, Dong Jin , Kim, Jin , Woo, Si Uk , Min, Byung Wook , Kim, Seon Hahn , Moon, Hong Young
- J Korean Soc Coloproctol. 2009;25(5):294-299.
- DOI: https://doi.org/10.3393/jksc.2009.25.5.294
- 1,670 View
- 7 Download
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Abstract
PDF
- 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.
- Mechanical Bowel Preparation for Elective Colorectal Surgery: A Prospective Randomized Study Comparing Polyethylene Glycol and Sodium Phosphate Oral Lavage Solutions.
- Yun, Seong Hyeon , Kang, Jung Gu
- J Korean Soc Coloproctol. 2004;20(1):27-31.
- 959 View
- 5 Download
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Abstract
PDF
- PURPOSE
This study was undertaken to determine whether a mechanical bowel preparation with 90 ml of sodium phosphate (NaP) solution (Group II) increased the acceptability of bowel preparation and reduced discomfort compared with 2 liters of polyethylene glycol (PEG) combined with a bisacodyl 20 mg (Group I).
METHODS
We conducted a prospective, randomized, single-blinded study. Forty-four patients undergoing elective colorectal surgery in the National Health Insurance Corporation Ilsan Hospital from March 2002 to November 2002 were included in this study. We assessed the patients' tolerance and cleansing ability, as well as the surgeon's satisfaction, by using a structured questionnaire. Postoperative complications were also evaluated.
RESULTS
Patient tolerance to NaP was higher than it was to PEG (P=0.034). The cleansing ability and the surgeon's satisfaction were not different between the two groups (P=0.217, P=0.349). There is no significant postoperative complication except for 1 case of wound infection in both group.
CONCLUSIONS
Both oral solutions proved to be equally effective and safe. However, patient tolerance to the small volume of NaP demonstrated a clear advantage over the traditional PEG solution.
- Mechanical Bowel Preparation for Elective Colorectal Surgery: A Prospective Randomized Study Comparing Two Liters and Four Liters of Polyethylene Glycol-Based Oral Lavage Solutions.
- Cho, Shin Il , Yun, Seong Hyun , Park, Jae Kun , Kim, Nam Kyu , Sohn, Seung Kook , Min, Jin Sik
- J Korean Soc Coloproctol. 2000;16(6):383-387.
- 1,115 View
- 15 Download
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Abstract
PDF
- PURPOSE
This study was undertaken to determine whether a mechanical bowel preparation with 2 liters polyethylene glycol solution combined with a Bisacodyl 20 mg (Group II) increases the acceptability of bowel preparation and reduces discomfort compared with 4 liters of polyethylene glycol solution (Group I).
METHODS
We conducted a prospective randomized single-blinded study. Eighty patients undergoing an elective colorectal surgery in Severance hospital from April 1999 to September 1999 were included in this study. The patients' tolerance, cleansing ability and surgeon's satisfaction were assessed by a structured questionnaire. Postoperative complications were also evaluated.
RESULTS
The patients' tolerance of the group II (2 liters polyethylene glycol solution combined with a Bisacodyl 20 mg) was better than that of the groups I (4 liters of polyethylene glycol solution). The cleaning ability and surgeon's satisfaction were not different between two groups (p=0.225, p=0.322). The incidence of postoperative complications was 2.3 percent in Group I and 2.7 percent in Group II.
CONCLUSIONS
The mechanical bowel preparation with two liters of polyethylene glycol solution with a Bisacodyl 20 mg was more comfortable to patients and equally efficient compared with the mechanical bowel preparation with the 4 liters of polyethylene glycol solution regimen before elective colorectal surgery.
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