[Standards and controversies in preoperative bowel preparation]

Area of Science:

• Gastroenterology
• Surgical Preparation

Background:

• Effective bowel preparation is crucial for colorectal surgery, aiming for adequate cleansing and bacterial reduction.
• Key considerations include patient tolerance, minimal side effects, and cost-effectiveness.
• Current methods include whole gut lavage, Golytely, and Prepacol.

Purpose of the Study:

• To compare the efficacy and safety of whole gut lavage with a new oral polyethylene glycol solution (Fordtran) for bowel preparation in colorectal surgery.
• To evaluate patient tolerance, side effects, cleansing effectiveness, and costs.

Main Methods:

• A prospective cohort study involving 100 patients undergoing colorectal surgery.
• Comparison between whole gut lavage and oral polyethylene glycol solution (Fordtran).
• Assessment of serum chloride levels, body weight changes, vomiting, subjective irritation, cleansing effect, and postoperative complications.

Main Results:

• Patients undergoing whole gut lavage showed significantly greater increases in serum chloride and body weight.
• Whole gut lavage also resulted in a higher frequency of vomiting and subjective irritation.
• No significant differences were observed in bowel cleansing efficacy or postoperative complication rates between the two methods.
• Oral polyethylene glycol solutions were found to be considerably less expensive.

Conclusions:

• Oral polyethylene glycol solutions are recommended for preoperative bowel preparation due to superior patient acceptance, reduced side effects, and lower costs.
• These findings align with existing literature, which suggests potential issues with other preparations like Prepacol regarding postoperative complications.