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Comparison of oral polyethylene glycol plus a large volume glycerine enema with a large volume glycerine enema alone in patients undergoing colorectal surgery for malignancy: a randomized clinical trial
Author(s) -
Bertani E.,
Chiappa A.,
Biffi R.,
Bianchi P. P.,
Radice D.,
Branchi V.,
Spampatti S.,
Vetrano I.,
Andreoni B.
Publication year - 2011
Publication title -
colorectal disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.029
H-Index - 89
eISSN - 1463-1318
pISSN - 1462-8910
DOI - 10.1111/j.1463-1318.2011.02689.x
Subject(s) - medicine , enema , randomized controlled trial , surgery , colorectal surgery , perioperative , colorectal cancer , incidence (geometry) , abdominal surgery , cancer , physics , optics
Aim Recent meta‐analyses and randomized clinical trials have concluded that mechanical bowel preparation (MBP) before elective colorectal surgery is not associated with a reduction of surgical site infection (SSI). The aim of this randomized clinical trial was to evaluate the impact of preoperative MBP for colon and rectal cancer surgery in comparison with a single glycerine enema. Method Patients scheduled for radical colorectal resection for malignancy with primary anastomosis were randomized to preoperative MBP (4 l of polyethylene glycol) (group 1, 114 patients) plus a glycerine 5% enema (2 l) or a single glycerine 5% enema (2 l) (group 2, 115 patients). The postoperative incidence of SSI was recorded prospectively. Patients undergoing minimally invasive surgery (laparoscopy or robotic) accounted for 55 and 51 in groups 1 and 2 respectively. Results In all, 229 patients were included in the study, 114 in group 1 and 115 in group 2. At least one SSI was reported in 16 (14.0%) group 1 and in 20 (17.8%) group 2 patients ( P = 0.475). Perioperative mortality was nil. The incidence of SSI was comparable also in the 73 patients who had a low anterior resection (seven of 33 vs eight of 40, P = 1.000), and for the 106 patients who underwent a minimally invasive procedure (nine of 55 vs four of 51, P = 0.241). Conclusion A single large‐volume glycerine enema is effective bowel preparation before colorectal resection whether performed by an open or minimally invasive technique.