[Standards and controversies in preoperative bowel preparation].
Bowel preparation for colorectal surgery should lead to sufficient bowel cleansing and reduction of fecal bacterial levels. It should be well tolerable for the patient and side effects should be rare. Finally the costs should be low. Today there are mainly three methods of significance: whole gut lavage, oral bowel preparation with Golytely-solutions and Prepacol (combination of bisacodyl tablets and sodium sulphate solution). We completed a prospective cohort study including 100 patients undergoing colorectal surgery in our hospital, comparing whole gut lavage with Fordtran, a new oral polyethylene glycol solution. In patients prepared with whole gut lavage the serum chloride levels and the body weight increased significantly more, the frequency of vomiting and subjective irritation was higher. There were no differences concerning the bowel cleansing effect and frequency of postoperative complications in both groups. The costs for oral polyethylene glycol solution are considerably lower. Our results match well with the published experiences of other authors. After bowel preparation with Prepacol a higher frequency of postoperative complications is reported. Due to better patient acceptance, lower side effects and lower costs, oral polyethylene glycol solutions are recommended as preoperative bowel preparation.
Seifert
J K
JK
Klinik und Poliklinik für Allgemein- und Abdominalchirurgie, Johannes Gutenberg-Universität, Mainz.
Junginger
T
T
D002400:Cathartics / Q000191:economics; D015331:Cohort Studies; D015179:Colorectal Neoplasms / Q000601:surgery*; D003362:Cost-Benefit Analysis; D011092:Polyethylene Glycols / Q000191:economics; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control*; D011300:Preoperative Care / Q000191:economics; D011446:Prospective Studies; D013529:Surgical Wound Dehiscence / Q000209:etiology / Q000517:prevention & control*; D013530:Surgical Wound Infection / Q000209:etiology / Q000517:prevention & control*; D007507:Therapeutic Irrigation / Q000191:economics
D002400:Cathartics; D011092:Polyethylene Glycols