Influence of unprepared bowel procedures on elective colorectal surgery

doi:10.3877/cma.j.issn.1674-0793.2021.04.008

Abstract

Abstract:

Objective

To explore the effect of elective colorectal surgery without preoperative bowel preparation.

Methods

From January 2015 to December 2017, 73 cases in Chengdu Third People’s Hospital undergoing elective colorectal tumor surgery without fistula were retrospectively analyzed. They were divided into conventional group (35 cases) and improved group (38 cases, without bowel preparation). The perioperative conditions and complications of the two groups were observed and compared.

Results

There were no significant differences in CRP, CD4/CD8, IL-6, blood glucose and serum albumin levels between the two groups 1 day before operation. There were no significant differences in operation time, intraoperative blood loss, first anal exhaust and defecation time, pulmonary infection, anastomotic leakage, SSI, intestinal obstruction and other postoperative complications between the two groups. The levels of CRP, IL-6, blood glucose and serum albumin in the conventional group were significantly higher than those in the improved group at 24 h and 3 d after operation (P<0.05).

Conclusions

Non preoperative bowel preparation can reduce the stress response of patients undergoing colorectal surgery, accelerate the rapid recovery after surgery, and does not increase the complications significantly. However, it is still necessary to evaluate the validity of bowel preparation scientifically and standardly.

Key words: Colorectal surgery, Bowel preparation, Stress response, Enhanced recovery after surgery

Shihong Li, Qinwang Niu, Yanjun Liu, Yuanchuan Zhang, Zhan Liu. Influence of unprepared bowel procedures on elective colorectal surgery[J]. Chinese Archives of General Surgery(Electronic Edition), 2021, 15(04): 278-281.

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References 19

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组别	例数	性别(例)		平均年龄(岁)	手术部位(人次)					手术方式(人次)
组别	例数	男	女	平均年龄(岁)	右半结肠	左半结肠	横结肠	乙状结肠	直肠	腹腔镜	开放手术
传统组	35	18	17	70.81±7.94	8	6	4	8	9	29	6
改进组	38	20	18	72.29±8.77	9	5	3	9	12	30	8
统计值		0.011		0.856^a	0.007	0.226	0.262	0.007	0.306	1.800
P值		0.918		0.394	0.933	0.634	0.608	0.933	0.580	0.672

组别	例数	性别(例)		平均年龄(岁)	手术部位(人次)					手术方式(人次)
组别	例数	男	女	平均年龄(岁)	右半结肠	左半结肠	横结肠	乙状结肠	直肠	腹腔镜	开放手术
传统组	35	18	17	70.81±7.94	8	6	4	8	9	29	6
改进组	38	20	18	72.29±8.77	9	5	3	9	12	30	8
统计值		0.011		0.856^a	0.007	0.226	0.262	0.007	0.306	1.800
P值		0.918		0.394	0.933	0.634	0.608	0.933	0.580	0.672

组别	例数	手术时间(min)	术中出血量(ml)	术后首次排气排便时间(h)
传统组	35	184.96±60.82	59.46±78.86	67.14±7.54
改进组	38	185.13±79.71	71.57±90.11	65.95±9.36
t值		0.010	0.609	0.598
P值		0.992	0.544	0.552

组别	例数	手术时间(min)	术中出血量(ml)	术后首次排气排便时间(h)
传统组	35	184.96±60.82	59.46±78.86	67.14±7.54
改进组	38	185.13±79.71	71.57±90.11	65.95±9.36
t值		0.010	0.609	0.598
P值		0.992	0.544	0.552

组别	例数	术后肠梗阻	吻合口漏	SSI	肺部感染
传统组	35	3(8.57)	1(2.86)	7(20.00)	1(2.86)
改进组	38	1(2.63)	1(2.63)	4(10.53)	1(2.63)
χ²值		1.241	0.003	1.278	0.003
P值		0.265	0.953	0.258	0.953

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