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Dysmotility by mechanical bowel preparation using polyethylene glycol

Takeshi Yamada1, Hayato Kan1, Satoshi Matsumoto1

  • 1Department of Gastrointestinal and Hepato-Billiary-Pancreatic Surgery, Nippon Medical School, Tokyo, Japan.

The Journal of Surgical Research
|May 27, 2014
PubMed
Abstract

Insights

Mechanical bowel preparation with polyethylene glycol (PEG) negatively impacts postoperative intestinal motility in colon cancer surgery. This study suggests that PEG-based mechanical bowel preparation is unnecessary for patients undergoing elective colon cancer surgery.

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.
Keywords:
Colon cancerEnhanced recovery after surgery (ERAS)Mechanical bowel preparation (MBP)Polyethylene glycol

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