Is preoperative bowel preparation necessary for gynecological oncology surgery?

Taiwan J Obstet Gynecol. 2016 Apr;55(2):198-201. doi: 10.1016/j.tjog.2016.02.009.

Abstract

Objective: We investigated the necessity of preoperative bowel preparation for gynecological oncology surgery.

Materials and methods: We retrospectively reviewed the medical records of patients who underwent gynecological oncology surgery with simultaneous colon or rectal resection between April 2005 and September 2014 at the Tri-Service General Hospital, Taipei, Taiwan. Patients were divided into two groups based on whether preoperative mechanical bowel preparation (MBP) was performed. Patient characteristics, including duration of antibiotic treatment, surgical procedures, and occurrence of surgical and nonsurgical complications, were compared.

Results: We enrolled 124 patients who underwent gynecological oncology surgery with simultaneous colon or rectal resection, of whom 76 received MBP and 48 did not receive mechanical bowel preparation. On comparison between the two groups, no significant differences were noted in the assessed patient characteristics, including mean age (p = 0.61), Federation of Gynecology and Obstetrics stage (p = 0.9), American Society of Anesthesiologists grade (p = 0.9), body mass index (p = 0.8), and residual tumor size (p = 0.86). Furthermore, duration of antibiotic treatment (p = 0.97), surgical procedures (p = 0.99), and total hospital days (p = 0.75), were not different between groups. The risk of surgical (p = 0.78) or nonsurgical (p = 1.0) complications was not significantly higher in the non-MBP group than in the MBP group.

Conclusion: MBP provides no significant benefit during gynecological oncology surgery. Thus, preoperative MBP is not essential before gynecological oncology surgery and can be omitted.

Keywords: complications; gynecological oncology surgery; preoperative mechanical bowel preparation.

MeSH terms

  • Abdominal Abscess / etiology
  • Aged
  • Anastomotic Leak / etiology
  • Anti-Bacterial Agents / administration & dosage*
  • Antibiotic Prophylaxis*
  • Colectomy* / adverse effects
  • Enema
  • Female
  • Genital Neoplasms, Female / surgery*
  • Humans
  • Laxatives / administration & dosage*
  • Middle Aged
  • Preoperative Care
  • Rectum / surgery*
  • Retrospective Studies
  • Surgical Wound Infection / etiology

Substances

  • Anti-Bacterial Agents
  • Laxatives