title: Dysmotility by mechanical bowel preparation using polyethylene glycol.
abstract: BACKGROUND
  The effects of mechanical bowel preparation (MBP) on morbidity (e.g., anastomotic leakage and surgical site infection) have been evaluated. Its effect on early recovery after surgery has drawn renewed attention, and its use is discouraged in the postsurgical management of enhanced recovery. However, most surgeons in Japan prefer polyethylene glycol (PEG) for MBP. We investigated the effect of MBP with PEG on postoperative intestinal motility.
  
  
  METHODS
  We prospectively evaluated a consecutive series of 258 colon cancer patients who underwent colonic resection and primary anastomosis. We orally administered 2000 mL of PEG in the PEG group and did not administer PEG to patients in the no-PEG group. Postoperative gastrointestinal motility was assessed with radiopaque markers. All patients ingested radiopaque markers 2 h before surgery. Postoperative intestinal motility was radiologically assessed by counting the number of residual markers. Abdominal radiography was conducted on postoperative days 1, 3, and 5 to count residual markers in the large and small intestines.
  
  
  RESULTS
  The total number of residual markers in the no-PEG group was less than that in the PEG group on day 5 (P < 0.01) but not on days 1 and 3. On all 3 d, the numbers of residual markers in the small intestine were significantly less in the no-PEG group than in the PEG group (P < 0.001). There were no differences in postoperative complications between the no-PEG and PEG groups.
  
  
  CONCLUSIONS
  PEG can negatively affect postoperative intestinal motility, and MBP using PEG is unnecessary in elective colon cancer surgery.
authors.affiliation: Department of Gastrointestinal and Hepato-Billiary-Pancreatic Surgery, Nippon Medical School, Tokyo, Japan. Electronic address: y-tak@nms.ac.jp.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Yamada
authors.affiliation: Department of Gastrointestinal and Hepato-Billiary-Pancreatic Surgery, Nippon Medical School, Tokyo, Japan.
authors.forename: Hayato
authors.initials: H
authors.lastname: Kan
authors.affiliation: Department of Gastrointestinal and Hepato-Billiary-Pancreatic Surgery, Nippon Medical School, Tokyo, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Matsumoto
authors.affiliation: Department of Gastrointestinal and Hepato-Billiary-Pancreatic Surgery, Nippon Medical School, Tokyo, Japan.
authors.forename: Michihiro
authors.initials: M
authors.lastname: Koizumi
authors.affiliation: Department of Gastrointestinal and Hepato-Billiary-Pancreatic Surgery, Nippon Medical School, Tokyo, Japan.
authors.forename: Akihisa
authors.initials: A
authors.lastname: Matsuda
authors.affiliation: Department of Gastrointestinal and Hepato-Billiary-Pancreatic Surgery, Nippon Medical School, Tokyo, Japan.
authors.forename: Seiichi
authors.initials: S
authors.lastname: Shinji
authors.affiliation: Department of Gastrointestinal and Hepato-Billiary-Pancreatic Surgery, Nippon Medical School, Tokyo, Japan.
authors.forename: Junpei
authors.initials: J
authors.lastname: Sasaki
authors.affiliation: Department of Gastrointestinal and Hepato-Billiary-Pancreatic Surgery, Nippon Medical School, Tokyo, Japan.
authors.forename: Eiji
authors.initials: E
authors.lastname: Uchida
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D057868:Anastomotic Leak / Q000517:prevention & control*; D003082:Colectomy / Q000009:adverse effects*; D003110:Colonic Neoplasms / Q000601:surgery*; D003125:Colostomy / Q000009:adverse effects; D017558:Elective Surgical Procedures / Q000009:adverse effects; D005260:Female; D005769:Gastrointestinal Motility / Q000187:drug effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011092:Polyethylene Glycols / Q000627:therapeutic use*; D011300:Preoperative Care / Q000379:methods; D011446:Prospective Studies; D020127:Recovery of Function; D013501:Surface-Active Agents / Q000627:therapeutic use; D013530:Surgical Wound Infection / Q000517:prevention & control*; D055815:Young Adult
chemical_list: D013501:Surface-Active Agents; D011092:Polyethylene Glycols
keywords: Colon cancer; Enhanced recovery after surgery (ERAS); Mechanical bowel preparation (MBP); Polyethylene glycol