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Preoperative mechanical preparation of the colon: the patient's experience.

Jung B, Lannerstad O, Påhlman L, Arodell M, Unosson M, Nilsson E - BMC Surg (2007)

Bottom Line: There was no significant difference between the two groups with respect to postoperative pain and nausea.On Day 4 (but not on Days 1 and 7 postoperatively) patients in the No-MBP group perceived more discomfort than patients in the MBP group, p = 0.02.Time to intake of fluid and solid food did not differ between the two groups.

View Article: PubMed Central - HTML - PubMed

Affiliation: University of Umeå and Department of Surgery, Visby Hospital, Visby Sweden. barbel.jung@hsf.gotland.se

ABSTRACT

Background: Preoperative mechanical bowel preparation can be questioned as standard procedure in colon surgery, based on the result from several randomised trials.

Methods: As part of a large multicenter trial, 105 patients planned for elective colon surgery for cancer, adenoma, or diverticulitis in three hospitals were asked to complete a questionnaire regarding perceived health including experience with bowel preparation. There were 39 questions, each having 3 - 10 answer alternatives, dealing with food intake, pain, discomfort, nausea/vomiting, gas distension, anxiety, tiredness, need of assistance with bowel preparation, and willingness to undergo the procedure again if necessary.

Results: 60 patients received mechanical bowel preparation (MBP) and 45 patients did not (No-MBP). In the MBP group 52% needed assistance with bowel preparation and 30% would consider undergoing the same preoperative procedure again. In the No-MBP group 65 % of the patients were positive to no bowel preparation. There was no significant difference between the two groups with respect to postoperative pain and nausea. On Day 4 (but not on Days 1 and 7 postoperatively) patients in the No-MBP group perceived more discomfort than patients in the MBP group, p = 0.02. Time to intake of fluid and solid food did not differ between the two groups. Bowel emptying occurred significantly earlier in the No-MBP group than in the MBP group, p = 0.03.

Conclusion: Mechanical bowel preparation is distressing for the patient and associated with a prolonged time to first bowel emptying.

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Height of boxes represents median of experienced nausea on Days 1, 4 and 7 postoperatively measured as value on a ten point Numerical Rating Scale. Vertical bars represent inter quartile-range. P < 0.05 considered significant (t-test).
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Figure 2: Height of boxes represents median of experienced nausea on Days 1, 4 and 7 postoperatively measured as value on a ten point Numerical Rating Scale. Vertical bars represent inter quartile-range. P < 0.05 considered significant (t-test).

Mentions: Only three statistically significant differences were noted between the two groups (Table 1, 2): willingness to consider the same preoperative procedure again time to first bowel movement (p = 0.04) and degree of discomfort on day 4 postoperatively (p = 0.02). The response rate in the No-MBP group to the question about the willingness to consider the same preoperative procedure again was low (58%) compared to the response rate in the MBP group (95%) (P < 0.001), see Table 4. Patients in the No-MBP group had their first bowel movement earlier than patients in the MBP group, see Table 5. Patients in the No-MBP group experienced a higher degree of discomfort (but not pain or nausea) on the fourth postoperative day compared to patients in the MBP group. For details see Figures 123.


Preoperative mechanical preparation of the colon: the patient's experience.

Jung B, Lannerstad O, Påhlman L, Arodell M, Unosson M, Nilsson E - BMC Surg (2007)

Height of boxes represents median of experienced nausea on Days 1, 4 and 7 postoperatively measured as value on a ten point Numerical Rating Scale. Vertical bars represent inter quartile-range. P < 0.05 considered significant (t-test).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC1884131&req=5

Figure 2: Height of boxes represents median of experienced nausea on Days 1, 4 and 7 postoperatively measured as value on a ten point Numerical Rating Scale. Vertical bars represent inter quartile-range. P < 0.05 considered significant (t-test).
Mentions: Only three statistically significant differences were noted between the two groups (Table 1, 2): willingness to consider the same preoperative procedure again time to first bowel movement (p = 0.04) and degree of discomfort on day 4 postoperatively (p = 0.02). The response rate in the No-MBP group to the question about the willingness to consider the same preoperative procedure again was low (58%) compared to the response rate in the MBP group (95%) (P < 0.001), see Table 4. Patients in the No-MBP group had their first bowel movement earlier than patients in the MBP group, see Table 5. Patients in the No-MBP group experienced a higher degree of discomfort (but not pain or nausea) on the fourth postoperative day compared to patients in the MBP group. For details see Figures 123.

Bottom Line: There was no significant difference between the two groups with respect to postoperative pain and nausea.On Day 4 (but not on Days 1 and 7 postoperatively) patients in the No-MBP group perceived more discomfort than patients in the MBP group, p = 0.02.Time to intake of fluid and solid food did not differ between the two groups.

View Article: PubMed Central - HTML - PubMed

Affiliation: University of Umeå and Department of Surgery, Visby Hospital, Visby Sweden. barbel.jung@hsf.gotland.se

ABSTRACT

Background: Preoperative mechanical bowel preparation can be questioned as standard procedure in colon surgery, based on the result from several randomised trials.

Methods: As part of a large multicenter trial, 105 patients planned for elective colon surgery for cancer, adenoma, or diverticulitis in three hospitals were asked to complete a questionnaire regarding perceived health including experience with bowel preparation. There were 39 questions, each having 3 - 10 answer alternatives, dealing with food intake, pain, discomfort, nausea/vomiting, gas distension, anxiety, tiredness, need of assistance with bowel preparation, and willingness to undergo the procedure again if necessary.

Results: 60 patients received mechanical bowel preparation (MBP) and 45 patients did not (No-MBP). In the MBP group 52% needed assistance with bowel preparation and 30% would consider undergoing the same preoperative procedure again. In the No-MBP group 65 % of the patients were positive to no bowel preparation. There was no significant difference between the two groups with respect to postoperative pain and nausea. On Day 4 (but not on Days 1 and 7 postoperatively) patients in the No-MBP group perceived more discomfort than patients in the MBP group, p = 0.02. Time to intake of fluid and solid food did not differ between the two groups. Bowel emptying occurred significantly earlier in the No-MBP group than in the MBP group, p = 0.03.

Conclusion: Mechanical bowel preparation is distressing for the patient and associated with a prolonged time to first bowel emptying.

Show MeSH
Related in: MedlinePlus