Gründel K, Schwenk W, Böhm B, Müller J M
Universitätsklinik für Chirurgie, Charité, Berlin.
Langenbecks Arch Chir. 1996;381(3):160-4. doi: 10.1007/BF00187621.
In a prospective randomized study in 100 patients undergoing conventional (n = 66) or laparoscopic (n = 34) colorectal resection, mechanical lavage with 2 l of a polyethylene glycol (PEG) solution (group A, n = 50) combined with a laxative was compared with lavage with 4 l of PEG alone (group B, n = 50). The influence of bowel preparation on postoperative ileus was investigated. The efficacy of bowel preparation was determined intraoperatively by a surgeon blind to the type of preparation. The time interval between the end of the operation an first flatus or bowel movement was recorded. The efficacy of preparation was no different between the groups (group A: 94%, group B: 84%; P = 0.5). The time lapse before first flatus (A: 3.1 +/- 1.2 days, B: 3.2 +/- 1.3 days; P = 0.6) or bowel movement (A: 3.9 +/- 1.3 days, B: 4.1 +/- 1.3 days; P = 0.5) also did not differ between the groups. The only factor found in multivariate analysis (age, sex, operation, duration and type of surgery, bowel preparation) to prolong the duration of postoperative ileus was the type of surgery. The first bowel movement occurred 3.2 +/- 1.1 days after conventional surgery and 4.3 +/- 1.2 days (P < 0.001) after laparoscopic surgery. The type of preoperative bowel preparation had no influence on the duration of postoperative ileus. The postoperative interval before the first bowel movement was shorter after laparoscopic surgery.
在一项针对100例行传统（n = 66）或腹腔镜（n = 34）结直肠切除术患者的前瞻性随机研究中，将2升聚乙二醇（PEG）溶液机械灌洗（A组，n = 50）联合泻药与仅用4升PEG灌洗（B组，n = 50）进行比较。研究肠道准备对术后肠梗阻的影响。肠道准备的效果由对准备类型不知情的外科医生在术中确定。记录手术结束至首次排气或排便的时间间隔。两组之间准备效果无差异（A组：94%，B组：84%；P = 0.5）。两组之间首次排气前的时间间隔（A组：3.1±1.2天，B组：3.2±1.3天；P = 0.6）或排便前的时间间隔（A组：3.9±1.3天，B组：4.1±1.3天；P = 0.5）也无差异。多因素分析（年龄、性别、手术、手术持续时间和类型、肠道准备）中发现的唯一延长术后肠梗阻持续时间的因素是手术类型。传统手术后首次排便发生在3.2±1.1天，腹腔镜手术后为4.3±1.2天（P < 0.001）。术前肠道准备类型对术后肠梗阻持续时间无影响。腹腔镜手术后首次排便前的术后间隔时间较短。
