Yoon Hyonjee, Park Jung Hyun, Mun Jisu, Yoon Youngjae, Lee Jin-Ju, Ko Minji, Cho Hyun-Hee, Namkung Jeong
Department of Obstetrics and Gynecology, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Gynecol Obstet Invest. 2025;90(2):93-99. doi: 10.1159/000541095. Epub 2024 Aug 26.
The objective of this randomized controlled trial was to compare the effect of bowel preparation using only oral polyethylene glycol electrolyte (PEG) solution versus oral PEG solution combined with mechanical sodium phosphate (NaP) enema on the surgical field visualization in patients undergoing robot-assisted laparoscopic gynecologic procedures.
Participants were randomized to either a single oral PEG solution or an oral PEG solution combined by mechanical NaP enema. The intraoperative visualization of the surgical field, the ease of manipulation of the bowels, and overall difficulty level of the surgery were evaluated by the surgeon using a self-administered questionnaire. After the surgery, the patients completed a survey assessing postoperative gastrointestinal discomfort.
A total of 114 women were enrolled and randomized to oral PEG solution-only group (n = 48), and oral PEG plus mechanical NaP enema group (n = 66). Forty-two women in oral PEG-only group and 59 oral PEG plus NaP enema group completed the study. There was no difference in intraoperative visualization or overall difficulty of the operation between the two groups, and bowel manipulation was easier in the oral PEG-only group. Also, there was no difference in operating time between the groups. The patients' level of gastrointestinal discomfort after the surgery was not significantly different between the two groups.
Routine use of mechanical NaP enema before robot-assisted laparoscopic gynecologic surgery is not recommended, because it has no additional benefit regarding intraoperative visualization or the surgical level of difficulty over oral bowel preparation methods.
本随机对照试验的目的是比较仅使用口服聚乙二醇电解质（PEG）溶液进行肠道准备与口服PEG溶液联合机械性磷酸钠（NaP）灌肠对接受机器人辅助腹腔镜妇科手术患者手术视野可视化的影响。
参与者被随机分为单口服PEG溶液组或口服PEG溶液联合机械性NaP灌肠组。外科医生使用自行填写的问卷对手术视野的术中可视化、肠道操作的难易程度以及手术的总体难度水平进行评估。手术后，患者完成一项评估术后胃肠道不适的调查。
共有114名女性入组并随机分为单纯口服PEG溶液组（n = 48）和口服PEG加机械性NaP灌肠组（n = 66）。单纯口服PEG溶液组的42名女性和口服PEG加NaP灌肠组的59名女性完成了研究。两组之间术中可视化或手术总体难度没有差异，且单纯口服PEG溶液组的肠道操作更容易。此外，两组之间的手术时间也没有差异。两组患者术后胃肠道不适程度没有显著差异。
不建议在机器人辅助腹腔镜妇科手术前常规使用机械性NaP灌肠，因为与口服肠道准备方法相比，它在术中可视化或手术难度水平方面没有额外益处。
