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International Journal of Colorectal Disease
Published in: International Journal of Colorectal Disease 7/2006

01-10-2006 | Original Article

Laparoscopic colectomy without mechanical bowel preparation

Authors: Oded Zmora, Alexander Lebedyev, Aviad Hoffman, Marat Khaikin, Yaron Munz, Moshe Shabtai, Amram Ayalon, Danny Rosin

Published in: International Journal of Colorectal Disease | Issue 7/2006

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Abstract

Background

Mechanical bowel preparation prior to colorectal surgery may reduce infectious complications, facilitate tumor localization, and allow intraoperative colonoscopy, if required. However, recent data suggest that mechanical bowel preparation may not facilitate a reduction in infectious complications. During laparoscopic colectomy, manual palpation is blunt, thereby potentially compromising tumor localization. The aim of this study was to assess the utility of mechanical bowel preparation in laparoscopic colectomy.

Materials and methods

A retrospective medical record review of all patients who underwent laparoscopic colectomy was performed. Patients were divided into two groups: those who had preoperative mechanical bowel preparation (Group A) or those who did not (Group B). All relevant perioperative data were reviewed and compared.

Results

Two hundred patients underwent laparoscopic colectomy; 68 (34%) were in Group A and 132 (66%) were in Group B. Sixteen (8%) patients required intraoperative colonoscopy for localization and were evenly distributed between the two groups. The incidence of conversion to laparotomy was slightly higher in Group B (14 vs 9%) due to difficult localization in some cases; however, this difference did not reach statistical significance. Furthermore, there was no significant difference in the postoperative complication rate between the two groups. Specifically, an anastomotic leak and a wound infection were recorded in 4 and 12% of patients in Group A compared to 3 and 17% in Group B, respectively.

Conclusions

Laparoscopic colectomy may be safely performed without preoperative mechanical bowel preparation, although difficult localization may lead to a slightly higher conversion rate. Appropriate patient selection for laparoscopic colectomy without mechanical bowel preparation is essential. Furthermore, bowel preparation should be considered in cases of small and nonpalpable lesions.
Literature
1.
Zmora O, Pikarsky AJ, Wexner SD (2001) Bowel preparation for colorectal surgery. Dis Colon Rectum 44:1537–1549PubMedCrossRef
2.
Burke P, Mealy K, Gillen P, Joyce W, Traynor O, Hyland J (1994) Requirement for bowel preparation in colorectal surgery. Br J Surg 81:907–910PubMedCrossRef
3.
Santos JC Jr, Batista J, Sirimarco MT, Guimaraes AS, Levy CE (1994) Prospective randomized trial of mechanical bowel preparation in patients undergoing elective colorectal surgery. Br J Surg 81:1673–1676PubMedCrossRef
4.
Miettinen RP, Laitinen ST, Makela JT, Paakkonen ME (2000) Bowel preparation with oral polyethylene glycol electrolyte solution vs. no preparation in elective open colorectal surgery: prospective, randomized study. Dis Colon Rectum 43:669–675PubMedCrossRef
5.
Zmora O, Mahajna A, Bar-Zakai B, Rosin D, Hershko D, Shabtai M, Krausz MM, Ayalon A (2003) Colon and rectal surgery without mechanical bowel preparation: a randomized prospective trial. Ann Surg 237:363–367CrossRefPubMed
6.
Bucher P, Gervaz P, Soravia C, Mermillod B, Erne M, Morel P (2005) Randomized clinical trial of mechanical bowel preparation versus no preparation before elective left-sided colorectal surgery. Br J Surg 92:409–414CrossRefPubMed
7.
Ram E, Sherman Y, Weil R, Vishne T, Kravarusic D, Dreznik Z (2005) Is mechanical bowel preparation mandatory for elective colon surgery? A prospective randomized study. Arch Surg 140:285–288CrossRefPubMed
8.
Kim SH, Milsom JW, Church JM, Ludwig KA, Garcia-Ruiz A, Okuda J, Fazio VW (1997) Perioperative tumor localization for laparoscopic colorectal surgery. Surg Endosc 11:1013–1016CrossRefPubMed
9.
Zmora O, Dinnewitzer AJ, Pikarsky AJ, Efron JE, Weiss EG, Nogueras JJ, Wexner SD (2002). Intraoperative endoscopy in laparoscopic colectomy. Surg Endosc 16:808–811CrossRefPubMed
10.
Platell C, Hall J (1998) What is the role of mechanical bowel preparation in patients undergoing colorectal surgery? Dis Colon Rectum 41:875–882PubMedCrossRef
11.
Slim K, Vicaut E, Panis Y, Chipponi J (2004) Meta-analysis of randomized clinical trials of colorectal surgery with or without mechanical bowel preparation. Br J Surg 91(9):1125–1130CrossRefPubMed
12.
Bucher P, Mermillod B, Gervaz P, Morel P (2004) Mechanical bowel preparation for elective colorectal surgery: a meta-analysis. Arch Surg 139(12):1359–1364CrossRefPubMed
13.
Guenaga K, Matos D, Castro A, Atallah A, Wille-Jorgensen P (2005) Mechanical bowel preparation for elective colorectal surgery. Cochrane Database Syst Rev 1:CD001544PubMed
14.
Rickard MJ, Bokey EL (2001) Laparoscopy for colon cancer. Surg Oncol Clin N Am 10:579–597PubMed
15.
Lacy AM, Garcia-Valdecasas JC, Delgado S, Castells A, Taura P, Pique JM, Visa J (2002) Laparoscopy-assisted colectomy versus open colectomy for treatment of non-metastatic colon cancer: a randomised trial. Lancet 359:2224–2229CrossRefPubMed
16.
Curet MJ, Putrakul K, Pitcher DE, Josloff RK, Zucker KA (2000) Laparoscopically assisted colon resection for colon carcinoma: perioperative results and long-term outcome. Surg Endosc 14:1062–1066CrossRefPubMed
17.
Botoman VA, Pietro M, Thirlby RC (1994) Localization of colonic lesions with endoscopic tattoo. Dis Colon Rectum 37:775–776CrossRefPubMed
18.
Montorsi M, Opocher E, Santambrogio R, Bianchi P, Faranda C, Arcidiacono P, Passoni GR, Cosentino F (1999) Original technique for small colorectal tumor localization during laparoscopic surgery. Dis Colon Rectum 42:819–822PubMedCrossRef
19.
Ballantyne GH, Leahy PF (2004) Hand-assisted laparoscopic colectomy: evolution to a clinically useful technique. Dis Colon Rectum 47:753–765CrossRefPubMed
Metadata
Title
Laparoscopic colectomy without mechanical bowel preparation
Authors
Oded Zmora
Alexander Lebedyev
Aviad Hoffman
Marat Khaikin
Yaron Munz
Moshe Shabtai
Amram Ayalon
Danny Rosin
Publication date
01-10-2006
Publisher
Springer-Verlag
Published in
International Journal of Colorectal Disease / Issue 7/2006
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI
https://doi.org/10.1007/s00384-005-0044-y

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