Does Using Comprehensive Preoperative Bowel Preparation Offer Any Advantage for Urinary Diversion Using Ileum? A Meta-analysis

Overview

Journal Int Urol Nephrol

Publisher Springer

Specialty Nephrology

Date 2012 Nov 20

PMID 23161374

Citations 2

Authors

Luo Yang

Heng-Shan Chen

Blayne Welk

John D Denstedt

Kunjie Wang

Hong Li

Qiang Wei

Xiang Li

Affiliations

Soon will be listed here.

Abstract

Purpose: The aim of this study was to compare the efficacy of comprehensive bowel preparation to that of limited bowel preparation in prevention of postoperative complications in elective urinary diversion surgery by using ileum.

Methods: Literature search of PubMed, EMBASE and the Cochrane Library was done to identify randomized controlled trials (RCTs) and cohort studies involving comparison of postoperative complications after comprehensive bowel preparation and limited bowel preparation. A meta-analysis was carried out to distinguish overall differences between the two groups.

Results: Our literature search yielded two randomized controlled trials and two cohort studies, involving a total of 346 patients, which met our inclusion criteria. There was no significant difference between the comprehensive bowel preparation and limited bowel preparation in wound infection [relative risk (RR) 95 % confidence interval (CI), 1.05(0.46-2.40); P = 0.86], mortality [RR 95 % CI, 1.06 (0.32-3.55); P = 0.76], ileus [RR 95 % CI, 0.86 (0.37, 2.00); P = 0.40], sepsis [RR 95 % CI, 0.71 (0.20, 2.52); P = 0.78], anastomotic leakage [RR 95 % CI, 0.81 (0.15, 4.21); P = 0.83], wound dehiscence [RR 95 % CI, 0.92 (0.40, 2.13); P = 0.67], peritonitis [RR 95 % CI, 0.64 (0.08, 5.10); P = 0.63] or fistula [RR 95 % CI, 0.71 (0.18,2.75); P = 0.63].

Conclusions: The limited evidence available demonstrated that the use of comprehensive bowel preparation for urinary diversion surgery using ileum does not offer any significant advantage over limited bowel preparation. Future work should target more high-quality RCTs to confirm this.

Citing Articles

Clinical efficacy and safety of enhanced recovery after surgery for patients treated with radical cystectomy and ileal urinary diversion: a systematic review and meta-analysis of randomized controlled trials.

Feng D, Liu S, Lu Y, Wei W, Han P Transl Androl Urol. 2020; 9(4):1743-1753.

PMID: 32944535 PMC: 7475686. DOI: 10.21037/tau-19-941.

Does Postoperative Rehabilitation for Radical Cystectomy Call for Enhanced Recovery after Surgery? A Systematic Review and Meta-analysis.

Xiao J, Wang M, He W, Wang J, Yang F, Ma X Curr Med Sci. 2019; 39(1):99-110.

PMID: 30868498 DOI: 10.1007/s11596-019-2006-6.

References

Wishnow K, Johnson D, Babaian R, Swanson D, Evans R, Von Eschenbach A . Effective outpatient use of polyethylene glycol-electrolyte bowel preparation for radical cystectomy and ileal conduit urinary diversion. Urology. 1988; 31(1):7-9. DOI: 10.1016/0090-4295(88)90561-4. View

Freiha F . Preoperative bowel preparation in urologic surgery. J Urol. 1977; 118(6):955-6. DOI: 10.1016/s0022-5347(17)58262-2. View

Bucher P, Gervaz P, Soravia C, Mermillod B, ERNE M, Morel P . Randomized clinical trial of mechanical bowel preparation versus no preparation before elective left-sided colorectal surgery. Br J Surg. 2005; 92(4):409-14. DOI: 10.1002/bjs.4900. View

Guenaga K, Matos D, Wille-Jorgensen P . Mechanical bowel preparation for elective colorectal surgery. Cochrane Database Syst Rev. 2011; (9):CD001544. PMC: 7066937. DOI: 10.1002/14651858.CD001544.pub4. View

Aslan G, Baltaci S, Akdogan B, Kuyumcuoglu U, Kaplan M, Cal C . A prospective randomized multicenter study of Turkish Society of Urooncology comparing two different mechanical bowel preparation methods for radical cystectomy. Urol Oncol. 2011; 31(5):664-70. DOI: 10.1016/j.urolonc.2011.03.009. View

Zhu Q, Zhang Q, Zeng Q, Yu Z, Tao C, Yang W . Efficacy of mechanical bowel preparation with polyethylene glycol in prevention of postoperative complications in elective colorectal surgery: a meta-analysis. Int J Colorectal Dis. 2009; 25(2):267-75. DOI: 10.1007/s00384-009-0834-8. View

Tabibi A, Simforoosh N, Basiri A, Ezzatnejad M, Abdi H, Farrokhi F . Bowel preparation versus no preparation before ileal urinary diversion. Urology. 2007; 70(4):654-8. DOI: 10.1016/j.urology.2007.06.1107. View

Pruthi R, Chun J, Richman M . Reducing time to oral diet and hospital discharge in patients undergoing radical cystectomy using a perioperative care plan. Urology. 2003; 62(4):661-5. DOI: 10.1016/s0090-4295(03)00651-4. View

Xu R, Zhao X, Zhong Z, Zhang L . No advantage is gained by preoperative bowel preparation in radical cystectomy and ileal conduit: a randomized controlled trial of 86 patients. Int Urol Nephrol. 2010; 42(4):947-50. DOI: 10.1007/s11255-010-9732-9. View

10.

Fa-Si-Oen P, Roumen R, Buitenweg J, van de Velde C, van Geldere D, Putter H . Mechanical bowel preparation or not? Outcome of a multicenter, randomized trial in elective open colon surgery. Dis Colon Rectum. 2005; 48(8):1509-16. DOI: 10.1007/s10350-005-0068-y. View

11.

Gundeti M, Godbole P, Wilcox D . Is bowel preparation required before cystoplasty in children?. J Urol. 2006; 176(4 Pt 1):1574-6. DOI: 10.1016/j.juro.2006.06.034. View

12.

Plumley P . A simple regime for preparation of colon before large-bowel surgery. Br J Surg. 1966; 53(5):413-4. DOI: 10.1002/bjs.1800530507. View

13.

Slim K, Flamein R, Brugere C . [Preoperative bowel preparation--is it useful?]. J Chir (Paris). 2004; 141(5):285-92. DOI: 10.1016/s0021-7697(04)95335-5. View

14.

Santos Jr J, Batista J, Sirimarco M, Guimaraes A, Levy C . Prospective randomized trial of mechanical bowel preparation in patients undergoing elective colorectal surgery. Br J Surg. 1994; 81(11):1673-6. DOI: 10.1002/bjs.1800811139. View

15.

Morey A, Evans L, McDonough 3rd R, Park A, Sexton W, Basler J . Evaluation of mechanical bowel preparation methods in urinary diversion surgery. Can J Urol. 2006; 13(5):3250-4. View

16.

Aslan G, Baltaci S, Cal C, Turkeri L, Gunlusoy B, Adsan O . Bowel preparation and peri-operative management for radical cystectomy in Turkey: Turkish Urooncology Association multicenter survey. Urol J. 2011; 8(2):113-9. View

17.

Slim K, Vicaut E, Panis Y, Chipponi J . Meta-analysis of randomized clinical trials of colorectal surgery with or without mechanical bowel preparation. Br J Surg. 2004; 91(9):1125-30. DOI: 10.1002/bjs.4651. View

18.

Bracken R, McDonald M, Johnson D . Cystectomy for superficial bladder cancer. Urology. 1981; 18(5):459-63. DOI: 10.1016/0090-4295(81)90289-2. View

19.

Ferguson K, McNeil J, Morey A . Mechanical and antibiotic bowel preparation for urinary diversion surgery. J Urol. 2002; 167(6):2352-6. View

20.

Guenaga K, Matos D, Wille-Jorgensen P . Mechanical bowel preparation for elective colorectal surgery. Cochrane Database Syst Rev. 2009; (1):CD001544. DOI: 10.1002/14651858.CD001544.pub3. View