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

Bertani, Emilio; Chiappa, Antonio; Biffi, R.; Bianchi, Paolo Pietro; Radice, Davide; Branchi, Vittorio; Spampatti, Sebastiano; Vetrano, Irene; Andreoni, B.

doi:10.1111/j.1463-1318.2011.02689.x

Cited by 22 publications

(26 citation statements)

References 30 publications

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“…published a randomized control trial comparing the use of MBP plus glycerine enema and glycerine enema alone in patients undergoing laparoscopic colonic resections. There was no significant difference in terms of surgical site infection and anastomotic leakage rate observed between the two groups [12] .…”

Section: Discussionmentioning

confidence: 67%

Laparoscopic colorectal resections with and without routine mechanical bowel preparation: A comparative study

Chan

Foo

Poon

et al. 2016

Annals of Medicine &Amp; Surgery

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BackgroundThe benefit of mechanical bowel preparation (MBP) in patients undergoing laparoscopic colorectal resections remains a question. This study aimed to evaluate the effect of omitting MBP on patients undergoing laparoscopic bowel resections.MethodsThe outcomes of patients who underwent elective colorectal resections for cancer of colon and upper rectum without MBP were compared to a retrospective cohort who had MBP.ResultsThere were 97 patients in the No-MBP group and 159 patients in the MBP group. Their mean age, operative risk, tumor size and stage of disease were similar. There were no significant differences in operative time and estimated blood loss. The anastomotic leakage rate was 1.0% in the No-MBP group and 0.6% in the MBP group, (p = 1.00). Wound infection rate were 4.1% and 3.8% in the No-MBP group and the MBP group respectively (p = 1.00). Overall surgical morbidity rate was 11.3% in the No-MBP group and 8.2% in the MBP group (p = 0.40). Conversion rates were 5.2% in the No-MBP group and 6.9% in the MBP group, (p = 0.57).ConclusionThe omission of mechanical bowel preparation does not increase surgical morbidities in patients undergoing laparoscopic bowel resections. It also has no effect on operating time and conversion rate.

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Section: Discussionmentioning

confidence: 67%

Laparoscopic colorectal resections with and without routine mechanical bowel preparation: A comparative study

Chan

Foo

Poon

et al. 2016

Annals of Medicine &Amp; Surgery

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“…Most studies used an open approach to CRS except for 2 studies 38,39 using a laparoscopic approach and 4 studies 18,21,33,49 reporting on data from a mix of open and laparoscopic procedures. Quality appraisal of included RCTs is summarized in eTable 1 in the Supplement.…”

Section: Resultsmentioning

confidence: 99%

“…17,18,23,25,27,28,30,31,33,53,54 In contrast, Bretagnol et al, 21 Contant et al, 24 and Platell et al 29 reported a lower risk of infectious complications with MBP. Bucher et al 22 and Santos et al 32 reported increased morbidity and infectious complications, respectively, with MBP.…”

Section: Discussionmentioning

confidence: 97%

Association of Mechanical Bowel Preparation and Oral Antibiotics Before Elective Colorectal Surgery With Surgical Site Infection

et al. 2018

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Key Points Question Which approach is best to reduce surgical site infections and anastomotic leak in colorectal surgery: mechanical bowel preparation with oral antibiotics, oral antibiotics only, mechanical bowel preparation only, or no preparation? Findings Among 38 randomized clinical trials (8458 patients) in this network meta-analysis, mechanical bowel preparation with oral antibiotics was associated with the lowest rate of surgical site infections, reducing both incisional and organ/space infections. There was no significant difference in anastomotic leak rate between the 4 approaches. Meaning Mechanical bowel preparation with oral antibiotics is the best approach to reduce surgical site infections in patients undergoing colorectal surgery.

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“…11 Glycerin has been well used and well studied in retrograde enemas and suppositories. 14–16 Overall, glycerin has a rather safe side effect profile, especially relative to other commonly used enema solutions. One histological comparison of rectal mucosa in rats subjected to either glycerin or phosphate enema demonstrated less irritation with glycerin.…”

Section: Discussionmentioning

confidence: 99%

Experience with Glycerin for Antegrade Continence Enema in Patients with Neurogenic Bowel

et al. 2013

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Purpose Malone antegrade continence enemas are used in the management of neurogenic bowel to attain fecal continence. Several different irrigation solutions have been described but glycerin, an osmotic laxative that promotes peristalsis, has rarely been mentioned or studied. We assessed clinical outcomes in our patients with a Malone antegrade continence enema using glycerin based irrigation. Materials and Methods We retrospectively reviewed patients with neurogenic bowel who underwent a Malone antegrade continence enema procedure between 1997 and 2011. Glycerin diluted with tap water followed by a tap water flush is our preferred irrigation protocol. Bowel regimen outcomes examined included fecal continence, emptying time, leakage from stoma, enema volume, frequency and independence. Results Of the 23 patients with followup greater than 6 months 19 used glycerin based irrigation. Average age at surgery was 8.8 years. Patients using glycerin instilled a median of 30 ml (mean 29) glycerin and 50 ml (131) tap water. Fecal continence rate was 95% and stoma leakage rate was 16%, and only 16% of patients required daily irrigation. Conclusions Glycerin is a viable and effective alternative irrigant for antegrade enemas of neurogenic bowel, with an excellent fecal continence rate. The volume of irrigant needed is typically less than 90 ml, which is much less than in published reports using tap water alone.

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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

Abstract: A single large-volume glycerine enema is effective bowel preparation before colorectal resection whether performed by an open or minimally invasive technique.

Cited by 22 publications

References 30 publications

Laparoscopic colorectal resections with and without routine mechanical bowel preparation: A comparative study

Laparoscopic colorectal resections with and without routine mechanical bowel preparation: A comparative study

Association of Mechanical Bowel Preparation and Oral Antibiotics Before Elective Colorectal Surgery With Surgical Site Infection

Experience with Glycerin for Antegrade Continence Enema in Patients with Neurogenic Bowel

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