title: Bowel preparation before laparoscopic gynaecological surgery in benign conditions using a 1-week low fibre diet: a surgeon blind, randomized and controlled trial.
abstract: OBJECTIVE
  The aim of this randomized, surgeon-blind, controlled study was to evaluate the role of a 7 days minimal-residue (low fibre intake) pre-operative diet compared with a mechanical bowel preparation in laparoscopic benign gynaecological surgery.
  
  
  METHODS
  This was a randomized, surgeon-blind, controlled study. The study included 83 women scheduled to undergo diagnostic or operative laparoscopy for various gynaecological benign conditions. Exclusion criteria were suspicion of malignancy, associated non-gynaecological surgical pathologies, severe endometriosis, and history of previous abdominal surgery. Study group had a total daily fibre intake inferior to 10 g for a week before the operation (n = 42). Control group had a mechanical bowel preparation the day before the operation (n = 41). The principal measures of outcome were the quality of bowel preparation, the acceptability of the preoperative diet and of the mechanical bowel preparation. Secondary outcomes included postoperative pain, time of ambulation, length of postoperative ileus, and length of postoperative hospital stay.
  
  
  RESULTS
  The two treatment groups were comparable with respect to demographic characteristics and indications for surgery. Preoperatively, abdominal distension and overall discomfort were significantly more frequent in the control group (P = 0.061 and 0.034 respectively). There was no significant difference in the small and large bowel preparation between the two groups. Postoperatively, no significant difference was observed between the two groups in pain, nausea, abdominal swelling, length of ileus, and of postoperative stay.
  
  
  CONCLUSIONS
  This study shows that preoperative low fibre diet and mechanical bowel preparation provide similar quality of surgical field exposure. However, when compared with mechanical bowel preparation, preoperative low fibre diet may be better tolerated by the patients, thus increasing compliance. Moreover, a 7 days preoperative low fibre diet allow the patient to continue working and social activities until the day of surgery without requiring admission to the hospital or home bowel preparation on the day before surgery.
authors.affiliation: Division of Obstetrics and Gynaecology, Department of Women and Children, Imperia Hospital, Via Sant' Agata, 57, 18100 Imperia, Italy. davide.lijoi@libero.it
authors.forename: Davide
authors.initials: D
authors.lastname: Lijoi
authors.forename: Simone
authors.initials: S
authors.lastname: Ferrero
authors.forename: Emanuela
authors.initials: E
authors.lastname: Mistrangelo
authors.forename: Ilaria Della
authors.initials: ID
authors.lastname: Casa
authors.forename: Marco
authors.initials: M
authors.lastname: Crosa
authors.forename: Valentino
authors.initials: V
authors.lastname: Remorgida
authors.forename: Franco
authors.initials: F
authors.lastname: Alessandri
mesh_terms: D000328:Adult; D002400:Cathartics / Q000008:administration & dosage; D004043:Dietary Fiber / Q000008:administration & dosage*; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000379:methods*; D006801:Humans; D045823:Ileus / Q000517:prevention & control; D007420:Intestine, Large / Q000378:metabolism; D010535:Laparoscopy / Q000379:methods*; D010149:Postoperative Pain / Q000517:prevention & control; D011092:Polyethylene Glycols / Q000008:administration & dosage; D011300:Preoperative Care / Q000379:methods*; D016037:Single-Blind Method; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D002400:Cathartics; D004043:Dietary Fiber; D011092:Polyethylene Glycols