Comparison of oral polyethylene glycol plus a large volume glycerine enema with a large volume glycerine enema alone in patients undergoing colorectal surgery for malignancy: A randomized clinical trial

Emilio Bertani, A. Chiappa, R. Biffi, P. P. Bianchi, D. Radice, V. Branchi, S. Spampatti, I. Vetrano, B. Andreoni

Research output: Contribution to journalArticle

Abstract

Aim: Recent meta-analyses and randomized clinical trials have concluded that mechanical bowel preparation (MBP) before elective colorectal surgery is not associated with a reduction of surgical site infection (SSI). The aim of this randomized clinical trial was to evaluate the impact of preoperative MBP for colon and rectal cancer surgery in comparison with a single glycerine enema. Method: Patients scheduled for radical colorectal resection for malignancy with primary anastomosis were randomized to preoperative MBP (4l of polyethylene glycol) (group 1, 114 patients) plus a glycerine 5% enema (2l) or a single glycerine 5% enema (2l) (group 2, 115 patients). The postoperative incidence of SSI was recorded prospectively. Patients undergoing minimally invasive surgery (laparoscopy or robotic) accounted for 55 and 51 in groups 1 and 2 respectively. Results: In all, 229 patients were included in the study, 114 in group 1 and 115 in group 2. At least one SSI was reported in 16 (14.0%) group 1 and in 20 (17.8%) group 2 patients (P=0.475). Perioperative mortality was nil. The incidence of SSI was comparable also in the 73 patients who had a low anterior resection (seven of 33 vs eight of 40, P=1.000), and for the 106 patients who underwent a minimally invasive procedure (nine of 55 vs four of 51, P=0.241). Conclusion: A single large-volume glycerine enema is effective bowel preparation before colorectal resection whether performed by an open or minimally invasive technique.

Original languageEnglish
JournalColorectal Disease
Volume13
Issue number10
DOIs
Publication statusPublished - Oct 2011

    Fingerprint

Keywords

  • Bowel enema
  • Colorectal cancer
  • Colorectal resection
  • Mechanical bowel preparation
  • Minimally invasive surgery

ASJC Scopus subject areas

  • Gastroenterology

Cite this