Department of Gynecologic Oncology, University of Health Sciences Turkey, Zeynep Kamil Women and Children's Diseases Training and Research Hospital, Istanbul, Turkey.
Department of General Surgery, University of Health Sciences Turkey, Zeynep Kamil Women and Children's Diseases Training and Research Hospital, Istanbul, Turkey.
J Invest Surg. 2022 Jul;35(7):1604-1608. doi: 10.1080/08941939.2022.2081389. Epub 2022 May 30.
To evaluate the effects of mechanical bowel preparation (MBP) on the intraoperative visualization of the surgical field, bowel handling, intestinal load, and overall ease of surgery in patients undergoing elective laparoscopic gynecological surgeries.
The patients randomized to a MBP group and a no preparation (NMBP) group. The senior surgeon remained blinded to the bowel regimen used by the patient. Intraoperative visualization of the surgical field, bowel handling, intestinal load, and overall ease of surgery were evaluated using a numeric rating scale (NRS).
We enrolled 120 patients, of whom 109 completed the study, with 51 and 58 patients in the MBP and NMBP groups, respectively. The intraoperative visualization of the surgical field, intestinal load, and NRS scores for overall ease of surgery were better in the NMBP group ( = .03, = .048, and = .022, respectively). The results of the assessments also revealed no significant differences in surgical field visualization, ease of bowel handling, overall ease of surgery, or the time that patients experienced passage of flatus between obese (BMI > 30 kg/m) and non-obese (BMI ≤ 30 kg/m) patients in the two groups.
The current study revealed that MBP did not improve the intraoperative visualization of the surgical field or the overall ease of surgery. Moreover, MBP had no benefit when operating on patients who had a high BMI. Therefore, we do not recommend routine MBP before laparoscopic gynecological surgeries.
评估机械肠道准备（MBP）对择期腹腔镜妇科手术患者术中手术视野可视化、肠道处理、肠道负荷和手术整体难易程度的影响。
患者随机分为 MBP 组和无准备（NMBP）组。高级外科医生对患者使用的肠道方案保持盲法。使用数字评分量表（NRS）评估术中手术视野可视化、肠道处理、肠道负荷和手术整体难易程度。
我们共纳入 120 例患者，其中 109 例完成了研究，MBP 组和 NMBP 组各有 51 例和 58 例患者。NMBP 组术中手术视野可视化、肠道负荷和手术整体难易程度的 NRS 评分更好（=0.03，=0.048，=0.022，分别）。评估结果还显示，两组肥胖（BMI>30kg/m）和非肥胖（BMI≤30kg/m）患者之间，手术视野可视化、肠道处理难易程度、手术整体难易程度或患者排气时间无显著差异。
本研究表明，MBP 并未改善手术视野的术中可视化或手术整体的难易程度。此外，对于 BMI 较高的患者，MBP 也没有益处。因此，我们不建议在腹腔镜妇科手术前常规进行 MBP。
