Zmora O, Pikarsky A J, Wexner S D
Department of Colorectal Surgery, Cleveland Clinic Florida, Weston, Florida 33331, USA.
Dis Colon Rectum. 2001 Oct;44(10):1537-49. doi: 10.1007/BF02234614.
The aim of this study was to assess recent literature regarding bowel preparation for colonoscopy and surgery.
The study was conducted by an Index Medicus English-language search of articles relevant to both oral mechanical and parenteral and oral antibiotic preparation for elective colorectal surgery and mechanical bowel preparation for colonoscopy. The study period was from 1975 to 2000. In addition, studies of elective colorectal surgery without mechanical bowel preparation were also considered.
Although several recent prospective, randomized trials have suggested that elective colorectal surgery can be safely performed without any mechanical bowel preparation, mechanical bowel preparation remains the standard of care, at least in North America at the present time. A recent survey of the members of The American Society of Colon and Rectal Surgeons revealed that the majority currently use sodium phosphate for bowel preparation and use a dual oral antibiotic regimen before elective colorectal surgery, combined with two doses of parenteral antibiotics. Although some of the use patterns are based on prospective, randomized study, others seem founded strictly on habit and theory.
The current methods of bowel cleansing for both colonoscopy and surgery include sodium phosphate and polyethylene glycol; colorectal surgeons practicing in North America currently prefer sodium phosphate. Additional preparation for colorectal surgery includes perioperative parenteral antibiotics and, to a slightly lesser degree, preoperative oral antibiotic preparation. Although some recent prospective, randomized studies have suggested that omission of mechanical bowel preparation for elective colorectal surgery is not only feasible but potentially preferable, caution is recommended before routinely omitting these widely practiced measures, because data to support such routine omission are limited.
本研究旨在评估近期有关结肠镜检查及手术肠道准备的文献。
通过医学索引（Index Medicus）对与择期结直肠手术的口服机械性肠道准备、肠外及口服抗生素准备以及结肠镜检查的机械性肠道准备相关的英文文章进行检索。研究时间段为1975年至2000年。此外，还考虑了未进行机械性肠道准备的择期结直肠手术的研究。
尽管近期多项前瞻性随机试验表明，择期结直肠手术可不进行任何机械性肠道准备而安全实施，但至少在目前的北美地区，机械性肠道准备仍是标准的治疗方法。美国结肠和直肠外科医师协会成员的一项近期调查显示，大多数人目前使用磷酸钠进行肠道准备，并在择期结直肠手术前采用双重口服抗生素方案，同时联合使用两剂肠外抗生素。尽管部分使用模式基于前瞻性随机研究，但其他模式似乎完全基于习惯和理论。
目前结肠镜检查和手术的肠道清洁方法包括磷酸钠和聚乙二醇；北美地区的结直肠外科医生目前更倾向于使用磷酸钠。结直肠手术的额外准备包括围手术期肠外抗生素，以及程度稍轻的术前口服抗生素准备。尽管近期一些前瞻性随机研究表明，择期结直肠手术省略机械性肠道准备不仅可行，而且可能更可取，但在常规省略这些广泛应用的措施之前，建议谨慎行事，因为支持这种常规省略的数据有限。
