DOI: http://dx.doi.org/10.18203/2349-2902.isj20201395

Hospital based randomized prospective study outcomes in colorectal surgery after bowel preparation

Altaf Hussain Bhat, Gh Hussain Mir, Sajad Ahmad Bhat, Muzaffar Ali

Abstract


Background: Research of so many years from the procurable world data has shown that the reasons for most colorectal cancers occur due to change in life style the type of diet, smoking as well as the influence of the surrounding environment in which man lives and increasing age with only a minority of cases associated with genetic disorders. Colorectal cancer is the third most commonly diagnosed cancer. In the first half of the 20th century, mortality from colorectal surgery often exceeded 20%, mainly attributed to sepsis.

Methods: The randomized prospective study was conducted on 202 colorectal cancer patients in the department of Colorectal division of General and Minimal Invasive surgery” Sher-i-Kashmir Institute of Medical Sciences, Srinagar.

Results: Mean age of patients in Group 1 (with no mechanical bowel preparation (NMBP)) was 51±18.15 years while as same was 50±17.76 years for Group 2 (with mechanical bowel preparation (MBP)). Age range for Group 1 was 16-87 years and16-85 years for Group 2. Regarding outcomes, wound infections were 6.1% and 3.8% in Group 1 and Group 2 respectively. While disruption of anastomosis were 2.0% and 3.8% in group A and B respectively.

Conclusions: Statistically no gross difference in terms of morbidity and mortality was found between the use of mechanical bowel preparation versus no use of mechanical bowel preparation in elective colorectal surgery. Elective Colorectal Surgery can safely be performed without enduring MBP in it as it does not possess any sorts of benefits.


Keywords


Colorectal, MBP, NMBP

Full Text:

PDF

References


Ahmad BS, Hussain MG, Basit R, Gumarova Z. Cancer antigens CEA,CA 19-9 as markers in colorectal carcinoma. Global J Res Analysis. 2019;8:3-6.

Center MM, Jemal A, Ward E. International trends in colorectal cancer incidence rates. Cancer Epidemiol Biomark Prev. 2009;18:1688-94.

Mir MM, Dar NA, Gochhait S, Zargar SA, Ahanger AG, Bamezai RN, et al. P53 mutation profile of squamous cell carcinoma of the esophagus in Kashmir (India): a high incidence area. Int J Center. 2005;116:62-8.

Sameer AS, Shah ZA, Nissar S, Mudassar S, Siddiqi MA. Risk of colorectal cancer associated with the methylene tetrahydrofolate reductase (MTHFR) C677T, polymorphism in the Kashmir population. J Genet Mol Res. 2011;10(2):1200-10.

Glenn F, Mcsherry CK. Carcinoma of the distal large bowel: 32 year review of 1026 cases. Ann Surg. 1966;163:838-49.

Brachman PS, Dan BB, Haley RW, Quade D, Freeman HE, Garner JS, et al. Nosocominal surgical infectious; incidence and cost. Surg Clin North Am. 1980;60:15-23.

Shah SKA, Memon GA, Rehman HU, Sahito RA, Leghari S, Baloch S. Bowel preparation: clinical outcomes in colorectal surgery after bowel preparation. Professional Med J. 2017;24(5):702-6.

Saha AK, Chowdhury F, Jha AK, Chatterjee S, Das A, Danu P, et al. Mechanical bowel preparation versus no preparation before colorectal surgery: a randomized prospective trial in a tertiary care institute. J Nat Sci Bio Med. 2014;5(2):421-4.

Delaney CP, Zutshi M, Senagore AJ, Remzi FH, Hammel J, Fazio VW, et al. Prospective, randomized, controlled trial between a pathway of controlled rehabilitation with early ambulation and diet and traditional postoperative care after laparotomy and intestinal resection. Dis Colon Rectum. 2003;46:851-9.

Teeuwen PH, Bleichrodt RP, Strik C, Groenewoud JJ, Brinkert W, Van Laarhoven CJ, et al. Enhanced recovery after surgery (ERAS) versus conventional postoperative care in colorectal surgery. J Gastrointest Surg. 2010;14:88-95.

Bhat AH, Parray FQ, Chowdri NA, Wani RA, Thakur N, Nazki S. Mechanical bowel preparation versus no preparation in electivecolorectal surgery: a prospective randomized study. Int J Surg Open. 2016;2:26-30.

Javid G, Zargar SA, Rather S, Khan AR, Khan BA, Yatoo GN, et al. Incidence of CRC in Kashmir valley. Ind Jr Gastroenterol. 2011:30(1):7-11.

Brownson P, Jenkins AS, Nott D, Ellenbogen S. Mechanical bowel preparation before colorectal surgery: results of a prospective randomized trial. Br J Surg.1992;79:461-2.

Fillmann EEP, Fillmann HS, Fillmann LS. Cirurgia colorectal eletiva sem prepare. Rev Brasil Coloproctol. 1995;15:70-1.

Caroline CM, Hop WC, Sant HP, Heres P, Oostvogel HJ, Stassen LP, et al. Mechanical bowel preparation for elective colorectal surgery: a multicentre randomizes trial. Lancet. 2007;370:2112-7.

Zmora O, Wexner SD, Hajjr L, Park T, Efron JE, Nogueras JJ, et al. Trends in preparation for colorectal surgery: survey of the members of the American society of colon and rectal surgeons. Am Surg. 2003;69:150-4.

Miettinen RP, Laitinen ST, Makela JT, Paakkonen ME. Bowel preparation with oral polyethylene glycol electrolyte solution vs. no preparation in the elective open colorectal surgery: prospective, randomnized study. Dis Colon Rectum. 2000;43:669-75.

Memon MA, Devine J, Freeney J, From SG. Is mechanical bowel preparation really necessary for elective colon and rectal surgery. Int J Colorectal Dis. 1997;12:298-302.