Kathopoulis Nikolaos, Chatzipapas Ioannis, Valsamidis Dimitrios, Samartzis Konstantinos, Kipriotis Konstantinos, Loutradis Dimitrios, Protopapas Athanasios
First Department of Obstetrics and Gynecology in Alexandra Hospital, National and Kapodistrian University of Athens, Athens, Greece.
Department of Anesthesia, Alexandra Hospital, Athens, Greece.
J Obstet Gynaecol Res. 2021 Apr;47(4):1487-1496. doi: 10.1111/jog.14674. Epub 2021 Feb 8.
To examine the influence of mechanical bowel preparation on surgical field visualization and patients' quality of life during benign gynecologic laparoscopic procedures.
A single blind, randomized, controlled trial was undertaken with laparoscopic gynecologic surgical patients to one of the following three groups: liquid diet on the preoperative day; mechanical bowel preparation with oral polyethylene glycol (PEG) solution; minimal residue diet for 3 days. Primary outcomes included assessment of the condition of small and large bowel and the overall quality of the surgical field. Additional measures included assessment of patients' preoperative symptoms, tolerance of the preparation method and compliance to the protocol, postoperative symptoms and bowel function.
One hundred forty-four patients were randomized as follows: 49 to liquid diet, 47 to mechanical bowel preparation, and 48 to minimal residue diet. Most characteristics were similar across groups. The intraoperative surgical view and the condition of large and small bowel were equal or inferior at the patients who received mechanical bowel preparation compared with the other groups. The 4-point Likert scale scoring for small bowel (2.51 vs. 2.72 vs. 2.81, p = 0.04), large bowel (2.26 vs. 2.38 vs. 2.48, p = 0.32) and overall operative field quality (2.34 vs. 2.67 vs. 2.67, p = 0.03) demonstrated no advantage from the use of preoperative mechanical bowel preparation over liquid diet and minimal residue diet, respectively. Preoperative discomfort was significantly greater in the mechanical bowel preparation group.
Mechanical bowel preparation before gynecologic laparoscopic operations for benign pathology could be safely abandoned.
ISRCTN registry, https://doi.org/10.1186/ISRCTN59502124 (No 59502124).
探讨肠道机械准备对妇科良性腹腔镜手术视野及患者生活质量的影响。
对接受腹腔镜妇科手术的患者进行单盲、随机对照试验，将其分为以下三组之一：术前日流食；口服聚乙二醇（PEG）溶液进行肠道机械准备；3天低渣饮食。主要结局包括评估小肠和大肠状况以及手术视野的整体质量。其他指标包括评估患者术前症状、对准备方法的耐受性和对方案的依从性、术后症状及肠道功能。
144例患者随机分组如下：49例接受流食，47例接受肠道机械准备，48例接受低渣饮食。各组的大多数特征相似。与其他组相比，接受肠道机械准备的患者术中手术视野以及小肠和大肠状况相同或较差。小肠（2.51 vs. 2.72 vs. 2.81，p = 0.04）、大肠（2.26 vs. 2.38 vs. 2.48，p = 0.32）和整体术野质量（2.34 vs. 2.67 vs. 2.67，p = 0.03）的4级李克特量表评分显示，术前肠道机械准备相对于流食和低渣饮食并无优势。肠道机械准备组术前不适明显更严重。
妇科腹腔镜良性病变手术前的肠道机械准备可安全摒弃。
ISRCTN注册库，https://doi.org/10.1186/ISRCTN59502124（编号59502124）。
