Bowel preparation for colorectal surgery: with and without mannitol.

Area of Science:

• Colorectal Surgery
• Pediatric Surgery
• Gastroenterology

Background:

• Mannitol is frequently used for bowel preparation in some regions due to limitations with other agents.
• Bowel preparation with mannitol is associated with several adverse effects.

Purpose of the Study:

• To compare the complications of mechanical bowel preparation with and without mannitol in patients undergoing colorectal surgery.

Main Methods:

• A case-control study involving 60 pediatric patients undergoing colorectal surgery (pull-through, colostomy closure, anorectoplasty).
• Patients were randomized into two groups: one receiving bowel preparation with mannitol and a control group without.
• Complications recorded included infection, electrolyte disturbances, fever, and leukocytosis.

Main Results:

• The study included 30 patients in each group, with similar mean ages.
• Patients prepared with mannitol experienced more instances of mild fever (38.1°C) and postsurgical fever within 48 hours.
• While not explicitly quantified for comparison, the results indicate a trend towards more fever in the mannitol group.

Conclusions:

• Hypernatremia, hypokalemia, and leukocytosis were more frequently observed in patients who underwent bowel preparation with mannitol.
• The findings suggest that mannitol-based bowel preparation may increase the risk of specific complications in pediatric surgical patients.