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Conference Paper: Laparoscopic colectomy with and without routine mechanical bowel preparation before operation: a comparative study

TitleLaparoscopic colectomy with and without routine mechanical bowel preparation before operation: a comparative study
Authors
Issue Date2012
PublisherThe University of Hong Kong.
Citation
The 7th Congress of the International Society of Laparoscopic Colorectal Surgery (ISLCRS 2012), Hong Kong, 2-4 November 2012. In Final Program, 2012, p. 14, abstract no. 8 How to Cite?
AbstractBACKGROUND: Although it is a common belief that preoperative mechanical bowel preparation (MBP) reduces the risk of complications after elective colorectal operations, many studies have shown that MBP does not improve operative outcomes. However, most of the evidence was from open surgery. The study evaluates the outcomes of elective laparoscopic colectomy with and without bowel preparation. METHODS: This is a retrospective comparative study of patients who had elective laparoscopic colectomy for colon cancer without preoperative MBP in our centre during the period of October 2009 to July 2011 (No-MBP group) and patients with MBP during Jan 2007 – May 2009 (MBP group). Patient demographics, operative outcomes, morbidity and mortality were retrieved from a prospective database and comparison between the two groups was compared. RESULTS: The No-MBP group had 97 patients and the MPB group had 159 patients. The mean age of No-MBP and MBP groups were both 70.7 (p = 0.988). Conversion rates in No-MBP and MBP groups were 5.2% and 6.9% respectively (p = 0.572). The ASA score of the patients, size of tumour and stage of disease were all similar in both groups. There were no significant difference between two groups in operative time, blood loss and hospital stay. The anastomotic leakage rates were the same (1%) in both groups. Two patients in No-MBP group (2.2%) and 1 patient (0.7%) in MBP group had intraabdominal collection (p = 0.560). Wound infection rate were 4.1% and 3.8% in No-MBP group and MBP group respectively (p = 1.000). Other surgical complication included postoperative bleeding [3 patients (3.1%) in No-MBP group & 1 patient (0.6%) in MBP group; p=0.560], intestinal obstruction [4 patients (4.1%) in No-MBP group & 1 patient (0.6%); p=0.07]. Total surgical morbidity rate was 11.3% in No-MBP group and 8.2 % in MBP group (p = 0.399). Six patients (6.2%) in No-MBP group and 4 patients (2.5%) in MBP group required reoperations (p=0.186). There was no mortality in No-MBP group and one mortality (0.6) in MBP group (p= 1.000). CONCLUSION: Preoperative MBP offers no additional benefits to laparoscopic colectomy for colon cancer and routine administration of preoperative MBP is not indicated.
Persistent Identifierhttp://hdl.handle.net/10722/187010

 

DC FieldValueLanguage
dc.contributor.authorChan, MYen_US
dc.contributor.authorPoon, JTCen_US
dc.contributor.authorLaw, WLen_US
dc.date.accessioned2013-08-20T12:26:40Z-
dc.date.available2013-08-20T12:26:40Z-
dc.date.issued2012en_US
dc.identifier.citationThe 7th Congress of the International Society of Laparoscopic Colorectal Surgery (ISLCRS 2012), Hong Kong, 2-4 November 2012. In Final Program, 2012, p. 14, abstract no. 8en_US
dc.identifier.urihttp://hdl.handle.net/10722/187010-
dc.description.abstractBACKGROUND: Although it is a common belief that preoperative mechanical bowel preparation (MBP) reduces the risk of complications after elective colorectal operations, many studies have shown that MBP does not improve operative outcomes. However, most of the evidence was from open surgery. The study evaluates the outcomes of elective laparoscopic colectomy with and without bowel preparation. METHODS: This is a retrospective comparative study of patients who had elective laparoscopic colectomy for colon cancer without preoperative MBP in our centre during the period of October 2009 to July 2011 (No-MBP group) and patients with MBP during Jan 2007 – May 2009 (MBP group). Patient demographics, operative outcomes, morbidity and mortality were retrieved from a prospective database and comparison between the two groups was compared. RESULTS: The No-MBP group had 97 patients and the MPB group had 159 patients. The mean age of No-MBP and MBP groups were both 70.7 (p = 0.988). Conversion rates in No-MBP and MBP groups were 5.2% and 6.9% respectively (p = 0.572). The ASA score of the patients, size of tumour and stage of disease were all similar in both groups. There were no significant difference between two groups in operative time, blood loss and hospital stay. The anastomotic leakage rates were the same (1%) in both groups. Two patients in No-MBP group (2.2%) and 1 patient (0.7%) in MBP group had intraabdominal collection (p = 0.560). Wound infection rate were 4.1% and 3.8% in No-MBP group and MBP group respectively (p = 1.000). Other surgical complication included postoperative bleeding [3 patients (3.1%) in No-MBP group & 1 patient (0.6%) in MBP group; p=0.560], intestinal obstruction [4 patients (4.1%) in No-MBP group & 1 patient (0.6%); p=0.07]. Total surgical morbidity rate was 11.3% in No-MBP group and 8.2 % in MBP group (p = 0.399). Six patients (6.2%) in No-MBP group and 4 patients (2.5%) in MBP group required reoperations (p=0.186). There was no mortality in No-MBP group and one mortality (0.6) in MBP group (p= 1.000). CONCLUSION: Preoperative MBP offers no additional benefits to laparoscopic colectomy for colon cancer and routine administration of preoperative MBP is not indicated.-
dc.languageengen_US
dc.publisherThe University of Hong Kong.-
dc.relation.ispartofCongress of the International Society of Laparoscopic Colorectal Surgery, ISLCRS 2012en_US
dc.rightsCreative Commons: Attribution 3.0 Hong Kong License-
dc.titleLaparoscopic colectomy with and without routine mechanical bowel preparation before operation: a comparative studyen_US
dc.typeConference_Paperen_US
dc.identifier.emailPoon, JTC: tcjensen@hku.hken_US
dc.identifier.emailLaw, WL: lawwl@hkucc.hku.hken_US
dc.identifier.authorityPoon, TCJ=rp01603en_US
dc.identifier.authorityLaw, WL=rp00436en_US
dc.description.naturepostprint-
dc.identifier.hkuros219380en_US
dc.identifier.spage14-
dc.identifier.epage14-
dc.publisher.placeHong Kong-

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