Rectal enema is an alternative to full mechanical bowel preparation for primary rectal cancer surgery.

Details

Serval ID
serval:BIB_C6AB17E530A2
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Rectal enema is an alternative to full mechanical bowel preparation for primary rectal cancer surgery.
Journal
Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland
Author(s)
Pittet O., Nocito A., Balke H., Duvoisin C., Clavien P.A., Demartines N., Hahnloser D.
ISSN
1463-1318 (Electronic)
ISSN-L
1462-8910
Publication state
Published
Issued date
2015
Peer-reviewed
Oui
Volume
17
Number
11
Pages
1007-1010
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
AIM: According to the French GRECCAR III randomized trial, full mechanical bowel preparation (MBP) for rectal surgery decreases the rate of postoperative morbidity, in particular postoperative infectious complications, but MBP is not well tolerated by the patient. The aim of the present study was to determine whether a preoperative rectal enema (RE) might be an alternative to MBP.
METHODS: An analysis was performed of 96 matched cohort patients undergoing rectal resection with primary anastomosis and protective ileostomy at two different university teaching hospitals, whose rectal cancer management was comparable except for the choice of preoperative bowel preparation (MBP or RE). Prospective databases were retrospectively analysed.
RESULTS: Patients were well matched for age, gender, body mass index and Charlson index. The surgical approach and cancer characteristics (level above anal verge, stage and use of neoadjuvant therapy) were comparable between the two groups. Anastomotic leakage occurred in 10% of patients having MBP and in 8% having RE (P = 1.00). Pelvic abscess formation (6% vs 2%, P = 0.63) and wound infection (8% vs 15%, P = 0.55) were also comparable. Extra-abdominal infection (13% vs 13%, P = 1.00) and non-infectious abdominal complications such as ileus and bleeding (27% and 31%, P = 0.83) were not significantly different. Overall morbidity was comparable in the two groups (50% vs 54%, P = 0.83).
CONCLUSION: A simple RE before rectal surgery seems not to be associated with more postoperative infectious complications nor a higher overall morbidity than MBP.
Keywords
Colectomy/methods, Enema/methods, Female, Follow-Up Studies, Humans, Ileostomy, Male, Middle Aged, Preoperative Care/methods, Rectal Neoplasms/mortality, Rectal Neoplasms/surgery, Rectum, Reproducibility of Results, Retrospective Studies
Pubmed
Web of science
Create date
03/11/2015 17:25
Last modification date
20/08/2019 15:42
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