Efficacy of preoperative bowel preparation at home

A preliminary study was designed to determine whether preoperative bowel preparation for colorectal surgery could be performed safely at home. Medical charts of 62 patients covering 4 years of elective major colorectal surgery done by a single general surgeon were retrospectively reviewed. Patients were divided into four groups, depending on the year in which they had surgery. Each patient had been given an easy-to-understand instruction sheet as well as prescriptions for mannitol solution, neomycin, and erythromycin base. The changeover from hospital-based to home-based bowel cleansing was gradual. In the first year of the study, all patients had bowel preparation in hospital; in the final year, 88% of patients had bowel cleansing at home. Home bowel preparation resulted in no identifiable increase in morbidity or mortality. No death or wound infection occurred in any patient group. Preoperative home bowel preparation can be done safely by the patient without increased morbidity or mortality. Ordering this preparation for most colorectal surgery patients could save about $150 million in hospital costs per year in the United States.