Effectiveness of Mechanical Bowel Preparation before Robot-Assisted Laparoscopic Gynecologic Surgery: A Randomized, Single-Blind, Controlled Trial.

IF 2 4区 医学 Q2 OBSTETRICS & GYNECOLOGY Gynecologic and Obstetric Investigation Pub Date : 2024-08-26 DOI:10.1159/000541095
Hyonjee Yoon, Jung Hyun Park, Jisu Mun, Youngjae Yoon, Jin-Ju Lee, Minji Ko, Hyun-Hee Cho, Jeong Namkung
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Abstract

Objective: The objective of this randomized controlled trial was to compare the effect of bowel preparation using only oral polyethylene glycol electrolyte (PEG) solution versus oral PEG solution combined with mechanical sodium phosphate (NaP) enema on the surgical field visualization in patients undergoing robot-assisted laparoscopic gynecologic procedures.

Methods: Participants were randomized to either a single oral PEG solution or an oral PEG solution combined by mechanical NaP enema. The intraoperative visualization of the surgical field, the ease of manipulation of the bowels, and overall difficulty level of the surgery were evaluated by the surgeon using a self-administered questionnaire. After the surgery, the patients completed a survey assessing postoperative gastrointestinal discomfort.

Results: A total of 114 women were enrolled and randomized to oral PEG solution-only group (n = 48), and oral PEG plus mechanical NaP enema group (n = 66). Forty-two women in oral PEG-only group and 59 oral PEG plus NaP enema group completed the study. There was no difference in intraoperative visualization or overall difficulty of the operation between the two groups, and bowel manipulation was easier in the oral PEG-only group. Also, there was no difference in operating time between the groups. The patients' level of gastrointestinal discomfort after the surgery was not significantly different between the two groups.

Conclusion: Routine use of mechanical NaP enema before robot-assisted laparoscopic gynecologic surgery is not recommended, because it has no additional benefit regarding intraoperative visualization or the surgical level of difficulty over oral bowel preparation methods.

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机器人辅助腹腔镜妇科手术前机械肠道准备的效果:随机、单盲、对照试验。
试验目的这项随机对照试验的目的是比较仅口服聚乙二醇电解质(PEG)溶液与口服聚乙二醇电解质溶液(PEG)联合机械磷酸钠(NaP)灌肠对接受机器人辅助腹腔镜妇科手术的患者手术视野的影响:方法:参与者被随机分配到单一口服PEG溶液或口服PEG溶液联合机械NaP灌肠。外科医生使用自制问卷对术中手术视野的可视性、肠道操作的难易程度以及手术的整体难度进行评估。术后,患者填写了一份评估术后胃肠道不适的调查表:114 名妇女入选并随机分为仅口服 PEG 溶液组(48 人)和口服 PEG 加机械 NaP 灌肠组(66 人)。仅口服 PEG 组 42 名妇女和口服 PEG 加 NaP 灌肠组 59 名妇女完成了研究。两组在术中可视化或整体手术难度方面没有差异,仅口服 PEG 组的肠道操作更容易。此外,两组的手术时间也没有差异。两组患者术后胃肠道不适程度无明显差异:结论:不建议在机器人辅助腹腔镜妇科手术前常规使用机械NaP灌肠,因为与口服肠道准备方法相比,机械NaP灌肠在术中可视化或手术难度方面没有额外的益处。
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来源期刊
CiteScore
4.20
自引率
4.80%
发文量
44
审稿时长
6-12 weeks
期刊介绍: This journal covers the most active and promising areas of current research in gynecology and obstetrics. Invited, well-referenced reviews by noted experts keep readers in touch with the general framework and direction of international study. Original papers report selected experimental and clinical investigations in all fields related to gynecology, obstetrics and reproduction. Short communications are published to allow immediate discussion of new data. The international and interdisciplinary character of this periodical provides an avenue to less accessible sources and to worldwide research for investigators and practitioners.
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