Laparoscopic colectomy without mechanical bowel preparation

Oded Zmora, Alexander Lebedyev, Aviad Hoffman, Marat Khaikin, Yaron Munz, Moshe Shabtai, Amram Ayalon, Danny Rosin

Research output: Contribution to journalReview articlepeer-review

Abstract

Background: Mechanical bowel preparation prior to colorectal surgery may reduce infectious complications, facilitate tumor localization, and allow intraoperative colonoscopy, if required. However, recent data suggest that mechanical bowel preparation may not facilitate a reduction in infectious complications. During laparoscopic colectomy, manual palpation is blunt, thereby potentially compromising tumor localization. The aim of this study was to assess the utility of mechanical bowel preparation in laparoscopic colectomy. Materials and methods: A retrospective medical record review of all patients who underwent laparoscopic colectomy was performed. Patients were divided into two groups: those who had preoperative mechanical bowel preparation (Group A) or those who did not (Group B). All relevant perioperative data were reviewed and compared. Results: Two hundred patients underwent laparoscopic colectomy; 68 (34%) were in Group A and 132 (66%) were in Group B. Sixteen (8%) patients required intraoperative colonoscopy for localization and were evenly distributed between the two groups. The incidence of conversion to laparotomy was slightly higher in Group B (14 vs 9%) due to difficult localization in some cases; however, this difference did not reach statistical significance. Furthermore, there was no significant difference in the postoperative complication rate between the two groups. Specifically, an anastomotic leak and a wound infection were recorded in 4 and 12% of patients in Group A compared to 3 and 17% in Group B, respectively. Conclusions: Laparoscopic colectomy may be safely performed without preoperative mechanical bowel preparation, although difficult localization may lead to a slightly higher conversion rate. Appropriate patient selection for laparoscopic colectomy without mechanical bowel preparation is essential. Furthermore, bowel preparation should be considered in cases of small and nonpalpable lesions.

Original languageEnglish
Pages (from-to)683-687
Number of pages5
JournalInternational Journal of Colorectal Disease
Volume21
Issue number7
DOIs
StatePublished - Oct 2006

Keywords

  • Colon surgery
  • Intraoperative endoscopy
  • Laparoscopic surgery
  • Polyethylene glycol
  • Preoperative care

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