Dysmotility by mechanical bowel preparation using polyethylene glycol.

Area of Science:

• Gastroenterology
• Surgical Oncology
• Colorectal Surgery

Background:

• Mechanical bowel preparation (MBP) effects on surgical morbidity are known.
• Early recovery post-surgery has gained attention, with MBP use discouraged in enhanced recovery protocols.
• Polyethylene glycol (PEG) is commonly preferred for MBP by Japanese surgeons.

Purpose of the Study:

• To investigate the impact of MBP using PEG on postoperative intestinal motility.
• To evaluate the necessity of PEG-based MBP in elective colon cancer surgery.

Main Methods:

• Prospective study of 258 colon cancer patients undergoing resection and anastomosis.
• Patients received either 2000 mL PEG (PEG group) or no PEG (no-PEG group).
• Postoperative intestinal motility assessed using radiopaque markers on days 1, 3, and 5 via abdominal radiography.

Main Results:

• Fewer residual markers observed in the no-PEG group on postoperative day 5 (P < 0.01).
• Significantly fewer residual markers in the small intestine for the no-PEG group on all assessed days (P < 0.001).
• No significant differences in postoperative complications between the PEG and no-PEG groups.

Conclusions:

• Polyethylene glycol (PEG) negatively affects postoperative intestinal motility.
• MBP using PEG is not necessary for elective colon cancer surgery.