Hu Yan-Jie, Li Ka, Li Li, Wang Xiao-Dong, Yang Jie, Feng Jin-Hua, Zhang Wei, Liu Yu-Wei
West China Hospital, Sichuan University, Chengdu 610041, China.E-mail:
Nan Fang Yi Ke Da Xue Xue Bao. 2017 Jan 20;37(1):13-17. doi: 10.3969/j.issn.1673-4254.2017.01.03.
To compared the early outcomes of patients undergoing elective surgeries for colon cancer with and without preoperative mechanical bowel preparation.
Between July, 2014 and February, 2016, patients undergoing elective surgery for colon cancer with primary anastomosis were randomly assigned into control group with mechanical bowel preparation 12 h before surgery and treatment group without mechanical bowel preparation. Baseline data collection was completed within 12 h after the operation. The levels of hemoglobin, total protein, albumin, prealbumin and albumin<globulin ratio of the patients were recorded at 1 day before surgery and 1 day and 5 days after the surgery. The patients were followed up till 30 days after the surgeries and the complications were recorded.
Seventy-six patients were assigned in the treatment group and 72 in the control group. Significant differences were found in the incidence of wound infection and intra-abdominal infection (P<0.05) but not in that of anastomotic leakage or early postoperative bowel obstruction (P>0.05) between the two 2 groups. The first flatus time (P=0.03) and prealbumin level on the first postoperative day (P=0.03) differed significantly between the two groups, but the operation time was similar between them (P=0.06).
In patients undergoing elective surgeries for colon cancer, preoperative mechanical bowel preparation is associated with increased postoperative complications, delayed recovery of intestinal motility and poorer nutrition status early after the operation.
比较接受择期结肠癌手术的患者术前进行与未进行机械性肠道准备的早期结局。
2014年7月至2016年2月期间,接受择期结肠癌手术并行一期吻合的患者被随机分为两组,对照组在术前12小时进行机械性肠道准备,治疗组不进行机械性肠道准备。术后12小时内完成基线数据收集。记录患者术前1天、术后1天和5天的血红蛋白、总蛋白、白蛋白、前白蛋白水平及白蛋白/球蛋白比值。对患者进行随访直至术后30天,并记录并发症情况。
治疗组分配76例患者,对照组分配72例患者。两组间伤口感染和腹腔内感染发生率存在显著差异(P<0.05),但吻合口漏或术后早期肠梗阻发生率无显著差异(P>0.05)。两组首次排气时间(P=0.03)和术后第1天的前白蛋白水平(P=0.03)存在显著差异,但手术时间相似(P=0.06)。
在接受择期结肠癌手术的患者中,术前机械性肠道准备与术后并发症增加、肠道动力恢复延迟及术后早期营养状况较差有关。