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Outpatient bowel preparation for elective colon resection
T H Le1, A E Timmcke, J B Gathright
1Department of Colon and Rectal Surgery, Ochsner Clinic, New Orleans, LA 70121, USA.
Southern Medical Journal
|May 1, 1997
Summary
Outpatient preoperative bowel preparation using polyethylene glycol-electrolyte lavage solution is as safe as inpatient preparation for colon surgery. This method offers significant cost savings for elective colectomy patients.
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.