Bowel preparation prior to laparoscopic colorectal resection: what is the current practice?
BACKGROUND
Much has been published on the role of mechanical bowel preparation (MBP) in open colorectal resection; however, the current study shows little evidence on the use of MBP prior to laparoscopic colorectal resections. In contrast to open procedures, MBP could influence the diameter of the bowel and thus the exposure of the surgical field in laparoscopy. This study aimed to assess the current practice of Dutch laparoscopic surgeons regarding MBP prior to colorectal resections.


METHODS
In January 2010, members of the Dutch Association for Endoscopic Surgery were invited to fill out an online questionnaire investigating whether MBP is prescribed prior to laparoscopic colorectal surgery, and which considerations are taken into account when choosing or omitting MBP.


RESULTS
The 82 (49%) returned questionnaires showed that 20% of respondents prescribe MBP prior to colonic resections, while 63% prescribe MBP prior to rectal resections. The most common reasons for giving MBP were the construction of a protective ileostoma (22%), improvement of the surgical field exposure (16%), and "other reasons" specified by free text (21%). The three most common reasons for conversion were inadequate surgical field exposure (88%), locally advanced tumor (68%), and adhesions (29%). Concerning the question which stages of the operation are influenced by MBP, 29% of respondents believed that the diameter of the small bowel was influenced by MBP, 29% indicated that the exposure of the surgical field was influenced by MBP, and 52% did not believe that any of the stages of the operation were influenced by MBP.


CONCLUSIONS
The results of this questionnaire indicate that the implementation of MBP in laparoscopic colorectal surgery is based on individual preferences in the Netherlands. This emphasizes the need of new studies investigating the role of MBP on surgical field exposure in colorectal laparoscopic surgery.
Department of Surgery, Erasmus Medical Centre, Rotterdam, the Netherlands. juliette_slieker@hotmail.com
Juliette C
JC
Slieker
Hans Pieter
HP
van't Sant
John
J
Vlot
Freek
F
Daams
Frank Willem
FW
Jansen
Johan F
JF
Lange
D002400:Cathartics / Q000627:therapeutic use*; D003107:Colorectal Surgery; D006801:Humans; D010535:Laparoscopy; D010818:Practice Patterns, Physicians'; D011300:Preoperative Care; D011795:Surveys and Questionnaires
D002400:Cathartics