Elimination of preoperative mechanical bowel preparation in patients undergoing cystectomy and urinary diversion

Raynor, Mathew C.; Lavien, Garjae; Nielsen, Matthew E.; Wallen, Eric; Pruthi, Raj S.

doi:10.1016/j.urolonc.2010.11.002

Cited by 48 publications

(24 citation statements)

References 10 publications

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“…Of these, 1 study lacked a control group [18], 2 studies made an inappropriate comparison [19,20], and 1 study focused on old people [21]; these studies were all excluded. In the end, 7 articles were identified for inclusion (two RCTs and five cohort studies) [10,11,12,13,22,23,24]. The overall risk of bias was unclear in 2 RCTs.…”

Section: Resultsmentioning

confidence: 99%

“…Two studies reported Clostridium difficile colitis and the results did not favor MBP [10,12] (OR 2.97; 95% CI 0.94-9.33; p = 0.06). Five studies described urinary tract infection or urosepsis and the pooled results did not favor MBP (OR 2.97; 95% CI 0.94-9.33; p = 0.06) [10,11,12,23,24]. Two studies reported non-urologic sepsis and no difference was found in the incidence with MBP (OR 0.71; 95% CI 0.10-5.15; p = 0.73) [11,12].…”

Section: Resultsmentioning

confidence: 99%

“…Five studies described urinary tract infection or urosepsis and the pooled results did not favor MBP (OR 2.97; 95% CI 0.94-9.33; p = 0.06) [10,11,12,23,24]. Two studies reported non-urologic sepsis and no difference was found in the incidence with MBP (OR 0.71; 95% CI 0.10-5.15; p = 0.73) [11,12]. Abdominal abscess was described in four studies [10,11,12,22]; no difference was found in the incidence with MBP (OR 0.53; 95% CI 0.15-1.87; p = 0.32).…”

Section: Resultsmentioning

confidence: 99%

“…Two studies reported non-urologic sepsis and no difference was found in the incidence with MBP (OR 0.71; 95% CI 0.10-5.15; p = 0.73) [11,12]. Abdominal abscess was described in four studies [10,11,12,22]; no difference was found in the incidence with MBP (OR 0.53; 95% CI 0.15-1.87; p = 0.32). Two studies reported peritonitis and no difference was found in the incidence with MBP [11,22] (OR 2.29; 95% CI 0.09-58.85; p = 0.62).…”

Section: Resultsmentioning

confidence: 99%

“…However, there were some limitations in their study. First, the sample size of this study was small because some important articles were not included [10,11,12,13]. In addition, limited BP was not really free preparation, but requested the patient to receive oral laxatives.…”

Section: Introductionmentioning

confidence: 99%

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The Role of Mechanical Bowel Preparation before Ileal Urinary Diversion: A Systematic Review and Meta-Analysis

et al. 2014

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Background: Although the use of mechanical bowel preparation (MBP) is still widely promoted as the dogma before patients undergo ileal urinary diversion, an increasing number of clinical trials have suggested that there is no benefit. Thus, we performed a meta-analysis to evaluate the efficacy of MBP in ileal urinary diversion surgery. Methods: A literature search was performed in electronic databases, including PubMed, Embase, Science Citation Index Expanded as well as the Cochrane Library and the Cochrane Clinical Trials Registry, from 1966 to January 1, 2013. Clinical trials comparing outcomes of MBP versus no MBP for ileal urinary diversion surgery were included in the meta-analysis. Pooled odds ratios with 95% confidence intervals were calculated using the fixed- or random-effects models. Results: In total, two randomized controlled trials and five cohort studies were included in this meta-analysis. The primary outcomes, such as bowel leak and bowel obstruction, showed no statistical difference between the two groups. Additionally, the overall mortality rate and death rate related to operation also manifested that MBP does not offer an advantage over the no MBP. Conclusion: This meta-analysis suggests that MBP does not reduce the incidence of perioperative complications in urinary diversion compared with no MBP. However, large randomized controlled clinical trials are needed to confirm this finding.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The Role of Mechanical Bowel Preparation before Ileal Urinary Diversion: A Systematic Review and Meta-Analysis

et al. 2014

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Radical cystectomy

Daneshmand¹,

Lerner²

2015

Bladder Cancer

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Integrated enhanced recovery after surgery protocol in radical cystectomy for bladder tumour—A retroprospective study

Ashraf,

Hamid,

Malik

et al. 2024

BJUI Compass

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IntroductionEnhanced recovery after surgery (ERAS) is a patient‐centerd, evidence‐based approach to improve postoperative outcomes. The protocol involves multidisciplinary collaboration and standardisation of perioperative interventions. ERAS has shown positive results in reducing hospitalisation and complications.MethodsThe study conducted in the Department of Urology was a retro‐prospective study. It included an ERAS cohort group of 47 patients, studied prospectively from May 2021 to May 2023. These patients were compared to a historical cohort of 47 consecutive patients who underwent radical cystectomy with traditional care before the ERAS pathway was implemented. The primary outcome was hospital length of stay (LOS). Secondary outcomes included perioperative management, time to recovery milestones and complications.ResultsImplementation of ERAS pathway for radical cystectomy was associated with reduced hospital LOS (mean LOS 16.19 ± 2.53 days vs. 10.26 ± 3.33 days 7 days; p < 0.0001), reduced time to key recovery milestones, including days to first flatus (3.17 vs. 2.68; p = 0.013) and days to first solid food (5.19 vs. 3.45 p value < 0.0001), first stool (5.53 vs. 4.23; p < 0.0001), reductions in some complications like postoperative ileus (p value = 0.021) and need for total parental nutrition (p value = 0.023).ConclusionIn conclusion, the implementation of the integrated approach facilitates a more efficient recovery process, potentially reducing healthcare costs and enhancing patient comfort.

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Elimination of preoperative mechanical bowel preparation in patients undergoing cystectomy and urinary diversion

Cited by 48 publications

References 10 publications

The Role of Mechanical Bowel Preparation before Ileal Urinary Diversion: A Systematic Review and Meta-Analysis

The Role of Mechanical Bowel Preparation before Ileal Urinary Diversion: A Systematic Review and Meta-Analysis

Radical cystectomy

Integrated enhanced recovery after surgery protocol in radical cystectomy for bladder tumour—A retroprospective study

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