title: Impact of Mechanical Bowel Preparation on Postoperative Outcomes after Liver Resection for Patients with Hepatocellular Carcinoma: A Single-Center Retrospective Cohort Study.
abstract: BACKGROUND
  Despite the routine use of mechanical bowel preparation (MBP), the real impact of MBP for liver resection remains unclear. The aim of this study was to evaluate the postoperative outcomes of MBP after liver resection for hepatocellular carcinoma (HCC).
  
  
  METHODS
  This was a retrospective cohort study of all patients undergoing liver resection for patients with HCC between from April 2008 to March 2015. MBP was defined as a preoperative medication of polyethylene glycol lavage. We compared perioperative outcomes in patients who did or did not receive MBP before liver resection. Open and laparoscopic hepatectomy were analyzed separately.
  
  
  RESULTS
  A total of 227 patients underwent potentially curative liver resection for HCC during the study period. One hundred twenty-eight patients received MBP while 99 did not. In the open hepatectomy group, overall and major (Clavien-Dindo ≥3) complications were equivalent between the groups (31.9 vs. 25.8%, p = 0.840; 12.1 vs. 8.7%, p = 0.475). There were no meaningful differences in the incidence of liver failure (MBP: 22.4%, non-MBP: 13.0%, p = 0.116). Surgical-site infections occurred in 20 (17.2%) vs. 10 (14.5%) with no significant difference (p = 0.624). Similar results were obtained from the laparoscopic hepatectomy group.
  
  
  CONCLUSIONS
  The use of MBP does not appear to impact the short outcomes after liver resection for patients with HCC. MBP might be omitted in liver surgery.
authors.affiliation: Department of Surgery, Nara Medical University, Shijo-cho, Kashihara-shi, Nara, Japan.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Hokuto
authors.forename: Takeo
authors.initials: T
authors.lastname: Nomi
authors.forename: Ichiro
authors.initials: I
authors.lastname: Yamato
authors.forename: Satoshi
authors.initials: S
authors.lastname: Yasuda
authors.forename: Shinsaku
authors.initials: S
authors.lastname: Obara
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Nakajima
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000601:surgery*; D002400:Cathartics / Q000627:therapeutic use*; D005260:Female; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011092:Polyethylene Glycols / Q000627:therapeutic use*; D011183:Postoperative Complications / Q000517:prevention & control*; D011300:Preoperative Care / Q000379:methods*; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D002400:Cathartics; D011092:Polyethylene Glycols