Bowel preparation for pull-through operation in Hirschsprung's disease
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Date
2010-01-15
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Songklanagarind Medical Journal
Abstract
Background/Purpose: Mechanical cleaning of the bowel is an essential component of preoperative bowel preparation. The aim of this study was to compare the adequacy of bowel preparation and patient outcomes.Methods: Medical records were retrospectively reviewed of 43 consecutive patients from 2001 to 2004 with Hirschsprung's disease who underwent a modified Duhamel's pull-through operation. Comparisons were made regarding adequacy of the bowel preparation at the time of the pull-through procedure, operating time, operative morbidity and length of hospital stay.Results: Thirteen patients had a preoperative colostomy and 30 patients had no colostomy. At the time of the pull-through procedure, the adequacy of the bowel preparation was recorded as fair (83.7%) or poor (16.3%). The wound complication rates of the fair and poor bowel preparation cases were 13.9% and 14.3%, respectively. The creation of a preoperative colostomy had no statistically significant effect on bowel preparation quality or postoperative complications.Conclusions: Mechanical bowel preparation showed no statistically significant effect in relation to bowel preparation quality or patient outcome. Thus good bowel preparation may not be necessary for elective colonic surgery in Hirschsprung's patients.
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Songklanagarind Medical Journal; Vol. 25 No. 5 Sep-Oct 2007; 401-406