Mechanical bowel preparation before gynecologic laparoscopy: a randomized, single-blind, controlled trial

Muzii, Ludovico; Bellati, Filippo; Zullo, Marzio Angelo; Manci, Natalina; Angioli, Roberto; Panici, Pierluigi Benedetti

doi:10.1016/j.fertnstert.2005.08.049

Cited by 65 publications

(71 citation statements)

References 17 publications

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“…Consistent with the results of the previous reports [4,6,7] , we did not find any differences in the surgeons' perspectives regarding the operative field visualization and the efficacy of bowel packing despite a presence of severe adhesions in 8-17% in each arm. This was consistent with 2 previous studies [6,7], which did not find a benefit of MBP in terms of operative visualization, bowel handing, and decreased operative complication. Furthermore, nearly 30% of the participants in our study were gynecologic cancer patients and 13% could have complete surgical staging without any MBP.…”

Section: Discussionsupporting

confidence: 92%

“…Wells et al [8] conducted an Internet survey of 110 gynecologic oncologists of Canada and found that 48% of them routinely ordered MBP and 77% of those physicians knew that there was no good evidence to support the benefits of MBP. From the patients' perspective, this study has considered more factors than the previous reports [6,7] and does not have significant differences among the 3 groups. Although we found that severe thirst was found to be significantly more severe in the no-enema and sodium chloride enema groups than in the SSE group on postoperative day one and more severe fatigue in the SSE group than in the no-enema group on discharge day, the low mean scores in both above-mentioned factors among these 3 groups (lower than 3) would have no clinical significance.…”

Section: Discussionmentioning

confidence: 99%

“…This might be due to the different types of interventions. Muzii et al [6] used oral sodium phosphate as catharsis compared with no MBP in gynecological laparoscopic surgery and found more impact of MBP on many aspects of QOL, such as, difficult in drinking, insomnia, weakness, abdominal distension, thirst, nausea, vomiting and overall discomfort. Another study compared 3 groups of no MBP, 2 days minimal residual diet, and 2 days minimal residual diet and MBP with oral sodium picosulphate in gynecological laparoscopic surgery.…”

Section: Discussionmentioning

confidence: 99%

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Appropriate Bowel Preparation for Laparotomy Gynecologic Surgery: A Prospective, Surgeon-Blinded Randomized Study

Suadee

Suprasert²

2016

Gynecol Obstet Invest

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Objective: To compare the surgeon's satisfaction during gynecological laparotomy surgery and patient's satisfaction as well as quality of life (QOL) among 3 groups of bowel preparations: no enema vs. sodium chloride enema vs. soap-suds enema (SSE). Materials and Method: Three hundred and thirty three women undergoing gynecological laparotomy surgery and without risks to bowel lumen entry between November 2014 and October 2015 were randomized to receive no enema (n = 111), sodium chloride enema (n = 111) or SSE (n = 111) for bowel preparation. Surgeons, who were blinded for the type of bowel preparation, assessed the surgical visualization and the efficacy of bowel packing. The patients' satisfaction and the QOL were also assessed on the days of admission, operation, post-operation, and discharge. Results: The patients' features of the 3 groups were well balanced. The surgeon's satisfaction was rated excellent as 56.8, 63.1 and 65.8% in the no-enema, sodium chloride and SSE groups (p = 0.830), respectively. The patients in the no-bowel-preparation group were satisfied more significantly than the other groups (p = 0.001). No significant differences in QOL were observed among the 3 groups. Conclusion: The type of bowel preparation for exploratory gynecologic surgery did not affect the surgical visualization and the QOL of the patients.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Appropriate Bowel Preparation for Laparotomy Gynecologic Surgery: A Prospective, Surgeon-Blinded Randomized Study

Suadee

Suprasert²

2016

Gynecol Obstet Invest

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“…One study compared the efficacy and adverse effects between oral sodium phosphate and sodium phosphate enema [18]. Four studies comparing MBP to non-MBP were meta-analyzed, non-MBP containing no bowel preparation or minimal residue diet [19,20,21,22]. One study comparing minimal residue diet plus oral sodium sulphate to minimal residue diet or fasting alone was also included in the meta-analysis [23].…”

Section: Resultsmentioning

confidence: 99%

“…Patient discomfort due to oral catharsis was significantly severer than in case of no bowel preparation and enema [18,21,22]. The symptoms were also much severer in the minimal residue diet plus MBP group than the fasting only group; however, they were not different when compared with minimal residue diet [23].…”

Section: Resultsmentioning

confidence: 99%

Is Mechanical Bowel Preparation Necessary for Gynecologic Surgery? A Systematic Review and Meta-Analysis

Zhang¹,

Xu²,

Su³

2015

Gynecol Obstet Invest

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Objective: To clarify the efficacy and side effects of mechanical bowel preparation (MBP) before gynecologic surgery. Methods: A systematic review was conducted. Embase, PubMed, the Cochrane Central Register of Controlled Trials in the Cochrane Library and China National Knowledge Infrastructure were searched. Randomized controlled trials on MBP prior to gynecologic surgery were included. The software package Revman 5.3 was used for statistical analysis. Odds ratio (OR) and standard mean deviation were calculated for dichotomous and continuous variable, respectively. Results: The quality of the included studies was moderate to good. MBP prior to laparoscopic gynecologic benign surgery or vaginal prolapse surgery has not been proven to be valuable for surgical performance, mainly involving visualization of the surgical field (OR 1.52, 95% confidence interval [CI] 1 to 2.32; Z = 1.95, p = 0.05), bowel handling (OR 2.21, 95% CI 0.83 to 5.84; Z = 1.59, p = 0.11), surgical complications (OR 1.3, 95% CI 0.46 to 3.67; Z = 0.5, p = 0.62) and bowel preparation. The discomfort due to oral catharsis is severer than no bowel preparation and enema, however without any difference between enema and no bowel preparation. Conclusion: The routine practice of MBP before gynecologic surgery needs to be reconsidered. This traditional clinical behavior has to be abandoned before benign laparoscopic surgery. Studies on the role of MBP for gynecologic laparotomy and gynecologic cancer are urgent.

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Perioperative Infections: Prevention and Therapeutic Options

Stenson

2011

Gynecologic Oncology

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Mechanical bowel preparation before gynecologic laparoscopy: a randomized, single-blind, controlled trial

Cited by 65 publications

References 17 publications

Appropriate Bowel Preparation for Laparotomy Gynecologic Surgery: A Prospective, Surgeon-Blinded Randomized Study

Appropriate Bowel Preparation for Laparotomy Gynecologic Surgery: A Prospective, Surgeon-Blinded Randomized Study

Is Mechanical Bowel Preparation Necessary for Gynecologic Surgery? A Systematic Review and Meta-Analysis

Perioperative Infections: Prevention and Therapeutic Options

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