Preoperative mechanical bowel preparation in elective colorectal surgery: an update of systematic review of the literature and meta-analysis

Güenaga, Katia Ferreira; Matos, Délcio; Wille‐Jørgensen, Peer

doi:10.1590/s2237-93632012000100002

Cited by 3 publications

(2 citation statements)

References 42 publications

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“…The colorectal surgery meta-analysis ( 33 ) showed no clinical benefit from mechanical bowel preparation. This study also pointed out that inadequate bowel preparation with the presence of liquid content increases the risk of infections.…”

Section: Preoperative Periodmentioning

confidence: 99%

Enhanced Recovery After Surgery Protocols in Major Urologic Surgery

Vuković

Dinić

2018

Front. Med.

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The purpose of the reviewThe analysis of the components of enhanced recovery after surgery (ERAS) protocols in urologic surgery.Recent findingsERAS protocols has been studied for over 20 years in different surgical procedures, mostly in colorectal surgery. The concept of improving patient care and reducing postoperative complications was also applied to major urologic surgery and especially procedure of radical cystectomy. This procedure is technically challenging, due to a major surgical resection and high postoperative complication rate that may reach 65%. Several clinical pathways were introduced to improve perioperative course and reduce the length of hospital stay. These protocols differ from ERAS modalities in other surgeries. The reasons for this are longer operative time, increased risk of perioperative transfusion and infection, and urinary diversion achieved using transposed intestinal segments. Previous studies in this area analyzed the need for mechanical bowel preparation, postoperative nasogastric tube decompression, as well as the duration of urinary drainage. Furthermore, the attention has also been drawn to perioperative fluid optimization, pain management, and bowel function.SummaryNotwithstanding partial resemblance between the pathways in major urologic surgery and other pelvic surgeries, there are still scarce guidelines for ERAS protocols in urology, which is why further studies should assess the importance of preoperative medical optimization, implementation of thoracic epidural anesthesia and analgesia, and perioperative nutritional management.

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Section: Preoperative Periodmentioning

confidence: 99%

Enhanced Recovery After Surgery Protocols in Major Urologic Surgery

Vuković

Dinić

2018

Front. Med.

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“…Thorough bowel cleansing is by most surgeons considered one of the most important factors in the prevention of complications 3 . In fact, since the days of Halsted, the presence of feces inside the colon has been viewed as a major cause of anastomotic dehiscence 4 .…”

Section: Introductionmentioning

confidence: 99%

Role of bowel preparation on colocolonic anastomosis: experimental study in dogs

Regadas¹,

Figueiredo²,

Nogueira³

et al. 2012

J. Coloproctol. (Rio J.)

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Comparative evaluation of healing response between colo-colic invagination anastomosis and single-layer running suture. Experimental study in dogs

Nogueira

Regadas

Bezerra

et al. 2016

Journal of Coloproctology

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Objective Evaluate healing response of colo-colic anastomosis by invagination vs. single-layer suture. Methods Sixty dogs were randomly distributed in two groups and anastomosed with single-layer suture (G-I, control) or by invagination and cardinal sutures (G-II, study). In the end, the animals were euthanized (10 from each group on POD7 and 20 on POD21) and the anastomosed segment was retrieved for histology and immunohistochemistry. Parameters included body weight, adhesions, edema, vasoproliferation, type I and III collagen, myeloperoxidase and nitric oxide. Findings were analyzed with Student's t test and the Mann–Whitney test. Results No animal died prior to euthanasia. The groups were similar with regard to all parameters: median weight 10.86 kg (G-I) and 9.98 kg (G-II) on POD7 (p = 0.41) and 11.86 kg (G-I) and 11.55 kg (G-II) on POD21 (p = 0.71); abdominal adhesions (p = 0.7383 POD7; p = 0.5685 POD21), level of edema (p = 0.3006 POD7; p = 0.7990 POD21), vasoproliferation (p = 0.1191 POD7; p = 0.0758 POD21), type I collagen (p = 0.4591 POD7; p = 0.3357 POD21), type III collagen (p = 0.2166 POD7; p = 0.2712 POD21), nitric oxide (p = 0.3980 POD7; p = 0.4796 POD21) and myeloperoxidase (p = 0.580 POD7; p = 0.755 POD21). Conclusion No significant difference in healing response was observed between the two anastomosis techniques (single-layer suture and invagination).

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Preoperative mechanical bowel preparation in elective colorectal surgery: an update of systematic review of the literature and meta-analysis

Cited by 3 publications

References 42 publications

Enhanced Recovery After Surgery Protocols in Major Urologic Surgery

Enhanced Recovery After Surgery Protocols in Major Urologic Surgery

Role of bowel preparation on colocolonic anastomosis: experimental study in dogs

Comparative evaluation of healing response between colo-colic invagination anastomosis and single-layer running suture. Experimental study in dogs

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