Mechanical bowel preparation before laparoscopic hysterectomy: a randomized controlled trial.
OBJECTIVE
To examine the influence of mechanical bowel preparation on surgical field visualization during laparoscopic hysterectomy.


METHODS
The study's primary outcome was the percentage of operations rated "good" or "excellent" in terms of surgical field visualization at the outset of the case by the primary surgeon. Additional measures included assessment of visualization during the case and patient perioperative comfort. The study was powered to detect a 20% absolute difference in the proportion of cases rated as "good" or "excellent."


RESULTS
Seventy-three patients were assigned to mechanical bowel preparation and 73 to no mechanical bowel preparation. The groups were comparable regarding patient and surgery characteristics. No differences were found for this rating between groups (mechanical bowel preparation, 64 of 73 patients [87.7%], compared with no mechanical bowel preparation, 60 of 73 patients [82.2%], P=.36). Surgeons guessed patient assignment correctly 59% of the time (42 of 71 patients) with mechanical bowel preparation and 55% of the time (41 of 75 patients) with no mechanical bowel preparation.


CONCLUSIONS
Mechanical bowel preparation is well-tolerated but does not influence surgical field visualization for laparoscopic hysterectomy.


BACKGROUND
ClinialTrials.gov, www.clinicaltrials.gov, NCT01576965.
University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
Matthew T
MT
Siedhoff
Leslie H
LH
Clark
Kumari A
KA
Hobbs
Austin D
AD
Findley
Janelle K
JK
Moulder
Joanne M
JM
Garrett
D000293:Adolescent; D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D002400:Cathartics / Q000008:administration & dosage*; D004733:Enema; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000379:methods*; D057194:Intention to Treat Analysis; D010535:Laparoscopy; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D017060:Patient Satisfaction; D010710:Phosphates / Q000008:administration & dosage*; D011300:Preoperative Care / Q000379:methods*; D011795:Surveys and Questionnaires; D055815:Young Adult
D002400:Cathartics; D010710:Phosphates; C018279:sodium phosphate