Outpatient bowel preparation for elective colon resection

Area of Science:

• Colorectal Surgery
• Gastroenterology
• Health Economics

Background:

• Preoperative bowel preparation is essential for elective colon surgery.
• Traditional inpatient preparation is resource-intensive and costly.

Purpose of the Study:

• To evaluate the safety and cost-effectiveness of outpatient bowel preparation.
• To compare outpatient versus inpatient preparation for colectomy.

Main Methods:

• Retrospective analysis of 726 colectomy cases (July 1987-July 1991).
• Comparison of 145 outpatient and 174 inpatient bowel preparation groups, matched for key demographics and comorbidities.
• Exclusion of patients requiring stoma, emergency surgery, or restorative proctocolectomy.

Main Results:

• No significant differences in hospitalization duration, nil per os (NPO) days, or nasogastric intubation requirements.
• Similar rates of postoperative complications, including wound infection, anastomotic leak, and mortality (one in each group).
• Outpatient preparation cost: ~$40; Inpatient preparation cost: ~$400.

Conclusions:

• Outpatient bowel preparation with polyethylene glycol-electrolyte lavage solution is a safe alternative to inpatient preparation.
• This approach leads to substantial cost savings for elective colon resections.
• Supports the adoption of outpatient preoperative bowel preparation to reduce healthcare expenditures.