Program of Minimally Invasive Gynecologic Surgery, Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts 02215, USA.
J Minim Invasive Gynecol. 2011 Mar-Apr;18(2):149-56. doi: 10.1016/j.jmig.2010.10.007. Epub 2010 Dec 16.
To compare the effect of mechanical bowel preparation using oral sodium phosphate (NaP) solution vs single NaP enema on the quality of the surgical field in patients undergoing advanced gynecologic laparoscopic procedures.
Single-blind randomized controlled trial (Canadian Task Force classification I).
Academic teaching hospital.
Women undergoing gynecologic laparoscopic surgery.
Administration of either oral NaP solution or single NaP enema for preoperative bowel preparation.
One hundred fifty-six women were enrolled, and 145 were randomized to receive either oral NaP solution (n = 72) or NaP enema (n = 73). Sixty-eight women in the oral solution group and 65 in the enema group completed the study. Assessment of the quality of the surgical field and bowel characteristics was performed using a surgeon questionnaire using Likert and visual analog scales. No significant differences were observed between the 2 groups in evaluation of the surgical field, bowel handling, degree of bowel preparation, or surgical difficulty. Surgical field quality was graded as excellent or good in 85% of women in the oral solution group and 91% of women in the enema group (p = .43). When surgeons were asked to guess the type of preparation used, they were correct only 52% of the time (κ = 0.04). Assessment of patient quality of life in the preoperative period was performed using a self-administered questionnaire using a visual analog scale. Severity of abdominal bloating and swelling, weakness, thirst, dizziness, nausea, fecal incontinence, and overall discomfort were significantly greater in the oral solution group. Women in the oral solution group also rated the preparation as significantly more difficult to administer, and were significantly less willing to try the same preparation in the future.
Quality of the surgical field in patients undergoing advanced gynecologic laparoscopic procedures is similar after mechanical bowel preparation using either oral NaP solution and NaP enema. Adverse effects are more severe with oral NaP solution compared with NaP enema administration.
比较口服磷酸钠（NaP）溶液与单次 NaP 灌肠在接受高级妇科腹腔镜手术的患者中对手术野质量的影响。
单盲随机对照试验（加拿大任务组分类 I）。
学术教学医院。
接受妇科腹腔镜手术的女性。
给予口服 NaP 溶液或单次 NaP 灌肠进行术前肠道准备。
共纳入 156 名女性，其中 145 名随机分为口服 NaP 溶液组（n=72）或 NaP 灌肠组（n=73）。口服溶液组 68 名女性和灌肠组 65 名女性完成了研究。使用 Likert 和视觉模拟量表的外科医生问卷评估手术野质量和肠道特征。两组在手术野评估、肠道处理、肠道准备程度或手术难度方面无显著差异。口服溶液组 85%的女性和灌肠组 91%的女性手术野质量评为优秀或良好（p=0.43）。当外科医生被要求猜测使用的准备类型时，他们只有 52%的时间猜对（κ=0.04）。使用视觉模拟量表的自我管理问卷评估术前患者生活质量。口服溶液组的腹胀和肿胀、虚弱、口渴、头晕、恶心、大便失禁和整体不适的严重程度显著更高。口服溶液组的女性还认为准备工作更难进行，并且将来尝试相同准备工作的意愿显著降低。
在接受高级妇科腹腔镜手术的患者中，使用口服 NaP 溶液和 NaP 灌肠进行机械肠道准备后，手术野质量相似。与 NaP 灌肠相比，口服 NaP 溶液的不良反应更严重。
