The Use of Mechanical Bowel Preparation in Pelvic Reconstructive Surgery: A Randomized Controlled Trial
Adelowo AO, Hacker MR, Modest AM, Apostolis CA, Disciullo AJ, Hanaway KJ, Elkadry EE, Rosenblatt PL, Rogers KJ, Hota LS
Female pelvic medicine & reconstructive surgery · 8 citations
How it was studied
- Design
- Randomized controlled trial (indexed by PubMed)
- Studied in
- People
- Main outcome
- Health markers and function
Who paid for it
- Funding
- Independent funding
- Government
- National Center for Research Resources
- Government
- National Center for Advancing Translational Sciences
- Government
- NCATS NIH HHS
- Government
- NCRR NIH HHS
- Grants
- National Center for Advancing Translational Sciences (UL1TR001102); National Center for Research Resources (UL1 RR 025758)
Based on 4 listed funder(s).
Publication
- Published
- 2016-10-26 · Female Pelvic Med Reconstr Surg · vol. 23 · issue 1 · pp. 1–7
- Publisher
- Lippincott Williams & Wilkins
- Cited
- 13 citations · more than 77% of similar papers · 0.9× the field average
- References
- 9 works
- Access
- Open access (repository copy)
- Research areas
- Surgical site infection prevention · Colorectal Cancer Surgical Treatments · Enhanced Recovery After Surgery
- Keywords
- Medicine, Randomized controlled trial, Reconstructive surgery, Surgery, General surgery
- MeSH
- pelvic floor, humans, phosphates, citric acid, organometallic compounds, cathartics, laparoscopy, enema, preoperative care, postoperative period, single-blind method, middle aged, female, pelvic organ prolapse, robotic surgical procedures, plastic surgery procedures
10 authors
From US
- Amos O. Adelowo · correspondingMount Auburn Hospital; Beth Israel Deaconess Medical Center; Harvard University; Reliant Medical Group
- Michele R. Hacker · correspondingMount Auburn Hospital; Beth Israel Deaconess Medical Center; Harvard University; Reliant Medical Group
- Anna Merport Modest · correspondingMount Auburn Hospital; Beth Israel Deaconess Medical Center; Harvard University; Reliant Medical Group
- Costa A. ApostolisMount Auburn Hospital; Beth Israel Deaconess Medical Center; Harvard University; Reliant Medical Group
- Anthony J. DiSciulloMount Auburn Hospital; Beth Israel Deaconess Medical Center; Harvard University; Reliant Medical Group
- K. HanawayMount Auburn Hospital; Beth Israel Deaconess Medical Center; Harvard University; Reliant Medical Group
Abstract
Objective
To compare mechanical bowel preparation (MBP) using oral magnesium citrate with sodium phosphate enema to sodium phosphate (NaP) enema alone during minimally invasive pelvic reconstructive surgery.
Methods
We conducted a single-blind, randomized controlled trial of MBP versus NaP in women undergoing minimally invasive pelvic reconstructive surgery. The primary outcome was intraoperative quality of the surgical field. Secondary outcomes included surgeon assessment of bowel handling and patient-reported tolerability symptoms.
Results
One hundred fifty-three participants were enrolled; 148 completed the study (71 MBP and 77 NaP). Patient demographics, clinical and intraoperative characteristics were similar. Completion of assigned bowel preparation was similar between MBP (97.2%) and NaP (97.4%). The MBP group found the preparation more difficult (P<0.01) and reported more overall discomfort and negative preoperative side effects (all P≤0.01). Quality of surgical field at initial port placement was excellent/good in 80.0% of the MBP group compared with 62.3% in the NaP group (P=0.02). This difference was not maintained by the conclusion of surgery (P=0.18). Similar results were seen in the intent-to-treat population. Surgeons accurately guessed preparation 65.7% of the time for MBP versus 41.6% for NaP (P=0.36). At 2 weeks postoperatively, both reported a median time for return of bowel function of 3.0 (2.0-4.0) days.
Conclusions
Mechanical bowel preparation with oral magnesium citrate before minimally invasive pelvic reconstructive surgery offered initial improvement in the quality of surgical field, but this benefit was not sustained. It was associated with an increase in patient discomfort preoperatively, but did not seem to impact postoperative return of bowel function.
Level of evidence
I.
Abstract via Europe PMC. Copyright remains with the authors or publisher.
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