Colectomy without mechanical bowel preparation in the private practice setting.


BACKGROUND:Despite randomized trials and meta-analyses demonstrating the safety of omitting mechanical bowel preparation (MBP) before colorectal surgery, private practice surgeons may hesitate to eliminate MBP for fear of being outside community standards. This study evaluated the safety of eliminating MBP before colectomy in a private practice setting. METHODS:This prospective observational study included elective abdominal colorectal operations from one surgeon's practice from October 2008 to June 2011. MBP was not routinely utilized after November 2009. Postoperative 30-day complication rates and length of hospital stay were compared in patients with and without MBP. Multivariable regression models were developed to compare outcomes among study groups, adjusting for demographics, diagnoses, procedures, and year. RESULTS:A total of 165 patients were analyzed. Demographics were similar between groups. Laparoscopic procedures were more common in patients without MBP due to increased laparoscopy over time (43 vs. 61 %, p = 0.03). As regards complications, infection rates were similar between groups (MBP 10.5 % vs. no MBP(NMBP) 11.4 %, adj p = 0.57). Patients without MBP had a shorter length of hospital stay (median: 6 vs. 5 days, p = 0.01), but those differences were not statistically significant after adjustment (p = 0.14). CONCLUSIONS:Private practice surgeons should embrace evidence-based practice changes and make efforts to quantitatively evaluate the safety of those changes. Omission of MBP for most elective colectomy procedures appears to be safe with no significant increase in complications or length of hospital stay. Because MBP has substantial drawbacks, there is little justification for its routine use in the majority of elective abdominal colorectal procedures.


Tech Coloproctol


Otchy DP,Crosby ME,Trickey AW




Has Abstract


2014-01-01 00:00:00












  • An evidence-based treatment algorithm for anal fissure.

    abstract::Guidelines for the treatment of anal fissure have been published in the USA and UK but differ. Many centers follow guidelines based on local experience. In December 2005, we met with the aim of developing an evidence-based treatment algorithm for anal fissure, applicable to both primary and secondary care. This algori...

    journal_title:Techniques in coloproctology

    pub_type: 共识发展会议,杂志文章


    authors: Lund JN,Nyström PO,Coremans G,Herold A,Karaitianos I,Spyrou M,Schouten WR,Sebastian AA,Pescatori M

    更新日期:2006-10-01 00:00:00

  • Fistulotomy or fistulectomy and primary sphincteroplasty for anal fistula (FIPS): a systematic review.

    abstract::There is still no clear consensus about surgical treatment of anal fistulas. Fistulotomy or fistulectomy and primary sphincter reconstruction is still regarded with skepticism. The aim of this systematic review was to evaluate the evidence in the literature supporting the use of this technique in the treatment of comp...

    journal_title:Techniques in coloproctology

    pub_type: 杂志文章,评审


    authors: Ratto C,Litta F,Donisi L,Parello A

    更新日期:2015-07-01 00:00:00

  • Agraffectomy after low rectal stapling procedures for hemorrhoids and rectocele.

    abstract:BACKGROUND:Various sequelae which might lead to reintervention have been described after stapled rectal mucosectomy for hemorrhoids. One potential treatment modality for persistent complaints after stapled hemorrhoidopexy (SHP) or stapling for rectocele is the so-called agraffectomy (removal of the retained staples). T...

    journal_title:Techniques in coloproctology

    pub_type: 杂志文章,评审


    authors: Petersen S,Jongen J,Schwenk W

    更新日期:2011-09-01 00:00:00

  • Laparoscopic total mesorectal excision.

    abstract::This article describes the operative technique that my colleagues and I apply to total mesorectal excision in patients with rectal cancer. A body of data support improvement of short-term outcomes over open resection. Although long-term data remain scarce, several ongoing trials may clarify this deficiency. The approp...

    journal_title:Techniques in coloproctology

    pub_type: 杂志文章


    authors: Khanna A

    更新日期:2013-02-01 00:00:00

  • Meta-analysis of randomized controlled trials comparing different techniques with primary closure for chronic pilonidal sinus.

    abstract:BACKGROUND:There are different open healing and primary closure approaches for chronic pilonidal sinus (CPD) that differ in principles and extension. AIMS:To compare the results of different closure surgical techniques, we performed a meta-analysis of randomized controlled trials (RCT) comparing: (1) open wide excisio...

    journal_title:Techniques in coloproctology

    pub_type: 杂志文章,meta分析


    authors: Enriquez-Navascues JM,Emparanza JI,Alkorta M,Placer C

    更新日期:2014-10-01 00:00:00

  • Perioperative outcomes and adverse events of robotic colorectal resections for inflammatory bowel disease: a systematic literature review.

    abstract::The purpose of this study was to assess outcome measures and cost-effectiveness of robotic colorectal resections in adult patients with inflammatory bowel disease. The Cochrane Library, PubMed/Medline and Embase databases were reviewed, using the text "robotic(s)" AND ("inflammatory bowel disease" OR "Crohn's" OR "Ulc...

    journal_title:Techniques in coloproctology

    pub_type: 杂志文章,评审


    authors: Renshaw S,Silva IL,Hotouras A,Wexner SD,Murphy J,Bhan C

    更新日期:2018-03-01 00:00:00

  • The trans-sphincteric posterior sagittal repair of recto-urinary and recto-vaginal fistulae using Surgisis™ mesh and fibrin sealant.

    abstract::Recto-urinary, recto-vaginal and ileo-anal pouch-associated fistulae are rare yet a significant clinical problem due to their profound impact on patients' quality of life and are a challenge to repair. In this report, we describe repair of these complex fistulae using a modified trans-sphincteric posterior sagittal ap...

    journal_title:Techniques in coloproctology

    pub_type: 杂志文章


    authors: Borowiec AM,McCall M,Lees GM

    更新日期:2014-02-01 00:00:00

  • Transperineal versus hydrogen peroxide-enhanced endoanal ultrasonography in never operated and recurrent cryptogenic fistula-in-ano: a pilot study.

    abstract:BACKGROUND:Accurate delineation of anal fistula anatomy in recurrent cases will assist in surgical fistula eradication whilst preserving continence. Recently, transperineal ultrasonography (TPUS) has been used in perirectal inflammation where there may be advantage over endoanal ultrasonography (EAUS) in complex fistul...

    journal_title:Techniques in coloproctology

    pub_type: 临床试验,杂志文章


    authors: Zbar AP,Oyetunji RO,Gill R

    更新日期:2006-12-01 00:00:00

  • A prospective case-control study of extralevator abdominoperineal excision (ELAPE) of the rectum versus conventional laparoscopic and open abdominoperineal excision: comparative analysis of short-term outcomes and quality of life.

    abstract:BACKGROUND:Conventional abdominoperineal excision (APE) of the rectum is associated with higher circumferential resection margin (CRM) involvement, increased local recurrence, and reduced survival compared to anterior resection. A more radical extralevator APE (ELAPE) technique may improve oncological outcome. However,...

    journal_title:Techniques in coloproctology

    pub_type: 杂志文章


    authors: Vaughan-Shaw PG,Cheung T,Knight JS,Nichols PH,Pilkington SA,Mirnezami AH

    更新日期:2012-10-01 00:00:00

  • The management of rectal cancer with synchronous liver metastases: a modern surgical dilemma.

    abstract:INTRODUCTION:One in ten patients with rectal cancer presents with synchronous colorectal liver metastases. We present an up-to-date review of the different surgical strategies available for rectal cancer patients with synchronous colorectal liver metastases. METHOD:A literature review of MEDLINE, Cochrane and Google s...

    journal_title:Techniques in coloproctology

    pub_type: 杂志文章,评审


    authors: Slesser AA,Bhangu A,Brown G,Mudan S,Tekkis PP

    更新日期:2013-02-01 00:00:00

  • Patient quality of life and short-term surgical outcomes between robotic and laparoscopic anterior resection for adenocarcinoma of the rectum.

    abstract:PURPOSE:To compare patient quality of life (QoL) and short-term surgical outcomes between robotic anterior resection (r-AR) and laparoscopic (l-AR) approach. METHODS:Consecutive patients having undergone either robotic or laparoscopic AR for adenocarcinoma were studied. All operations were performed by two surgeons ex...

    journal_title:Techniques in coloproctology

    pub_type: 杂志文章


    authors: Kamali D,Omar K,Imam SZ,Jha A,Reddy A,Jha M

    更新日期:2017-05-01 00:00:00

  • Oral lacidipine in the treatment of anal fissure.

    abstract::The aim of this prospective study was to assess the effectiveness in healing anal fissure (AF) of lacidipine, a calcium channel blocker with a better tolerability in comparison to other calcium antagonists. Twenty-one consecutive patients (16 women, 76.2%) with AF (16 chronic, situated posteriorly in 17 patients (81.0...

    journal_title:Techniques in coloproctology

    pub_type: 临床试验,杂志文章


    authors: Ansaloni L,Bernabè A,Ghetti R,Riccardi R,Tranchino RM,Gardini G

    更新日期:2002-09-01 00:00:00

  • Transanal resection of rectal neoplasms using the Harmonic Scalpel.

    abstract::The currently used technology for transanal excision of rectal neoplasms is diathermy. However, control of bleeding is sometimes difficult. The Harmonic Scalpel provides a "dry" surgical field which facilitates the procedure and allows complete resection of the neoplasm with greater accuracy. ...

    journal_title:Techniques in coloproctology

    pub_type: 杂志文章


    authors: Rabau M

    更新日期:2008-09-01 00:00:00

  • Posterior perineal support as treatment for anal fissures--preliminary results with a new toilet seat device.

    abstract:BACKGROUND:Anal fissures can cause morbidity in an otherwise healthy young patient. The process of evacuation results in stretching and descent of the anoderm and perineum especially posteriorly. Posterior perineal support may provide counter pressure at the posterior aspect of the pelvic floor, balancing the pressure ...

    journal_title:Techniques in coloproctology

    pub_type: 杂志文章


    authors: Tan KY,Seow-Choen F,Hai CH,Thye GK

    更新日期:2009-03-01 00:00:00

  • Serotonin receptors and their role in the pathophysiology and therapy of irritable bowel syndrome.

    abstract:BACKGROUND:Irritable bowel syndrome (IBS) is a functional disorder of the gastrointestinal tract characterized by abdominal discomfort, pain and changes in bowel habits, often associated with psychological/psychiatric disorders. It has been suggested that the development of IBS may be related to the body's response to ...

    journal_title:Techniques in coloproctology

    pub_type: 杂志文章,评审


    authors: Stasi C,Bellini M,Bassotti G,Blandizzi C,Milani S

    更新日期:2014-07-01 00:00:00

  • Poor outcome of sphincter repair: an evacuation problem?

    abstract:INTRODUCTION:Colorectal transport in idiopathic fecal incontinence has scarcely been studied, and it remains to be investigated in patients with fecal incontinence and anal sphincter lesion. The aim of the present study was to compare colorectal transport during defecation in patients with idiopathic fecal incontinence...

    journal_title:Techniques in coloproctology

    pub_type: 杂志文章


    authors: Michelsen HB,Christensen P,Buntzen S,Laurberg S,Krogh K

    更新日期:2011-03-01 00:00:00

  • Surgical site infection rates: open versus hand-assisted colorectal resections.

    abstract:PURPOSE:This study was performed to determine impact of open and hand-assisted colorectal resection on surgical site infection (SSI) rates. METHODS:National Surgical Quality Improvement Project data from 2006 to 2008 were supplemented with an institutional review board-approved chart review. Primary endpoint was SSI r...

    journal_title:Techniques in coloproctology

    pub_type: 杂志文章


    authors: Bishawi M,Fakhoury M,Denoya PI,Stein S,Bergamaschi R

    更新日期:2014-04-01 00:00:00

  • Transanal endoscopic microsurgery: indications, results and controversies.

    abstract::Transanal endoscopic microsurgery (TEM) was introduced in 1983 as a minimally invasive technique allowing the resection of adenomas and early rectal carcinomas unsuitable for local or colonoscopic excision which would otherwise require major surgery. After 25 years, there is still much debate about the procedure. This...

    journal_title:Techniques in coloproctology

    pub_type: 杂志文章,评审


    authors: Dias AR,Nahas CS,Marques CF,Nahas SC,Cecconello I

    更新日期:2009-06-01 00:00:00

  • An unusual cause of obstructed defecation.

    abstract::Obstructed defecation is one subtype of constipation, and may be due to functional or mechanical causes. Here, we report an unusual cause, never described before, of obstructed defecation due to a large uterine myoma that reverted to normal bowel habits after surgery. The importance of an accurate evaluation of the ca...

    journal_title:Techniques in coloproctology

    pub_type: 杂志文章


    authors: Solè LI,Rosato G,Bolino MC,Bassotti G

    更新日期:2009-09-01 00:00:00

  • Is-it possible to distinguish irritable bowel syndrome with constipation from functional constipation?

    abstract:BACKGROUND:The Rome III criteria classify patients complaining of constipation into two main groups: patients with functional constipation (FC) and patients with constipation predominant irritable bowel syndrome (IBS-C). The purpose of this study was to identify differences in the intensity of symptoms and total and se...

    journal_title:Techniques in coloproctology

    pub_type: 杂志文章


    authors: Bouchoucha M,Devroede G,Bon C,Bejou B,Mary F,Benamouzig R

    更新日期:2017-02-01 00:00:00

  • Preoperative staging of perforated diverticulitis by computed tomography scanning.

    abstract:BACKGROUND:Treatment of perforated diverticulitis depends on disease severity classified according to Hinchey's preoperative classification. This study assessed the accuracy of preoperative staging of perforated diverticulitis by computerized tomography (CT) scanning. METHODS:All patients who presented with perforated...

    journal_title:Techniques in coloproctology

    pub_type: 杂志文章


    authors: Gielens MP,Mulder IM,van der Harst E,Gosselink MP,Kraal KJ,Teng HT,Lange JF,Vermeulen J

    更新日期:2012-10-01 00:00:00

  • A review of chronic anal fissure management.

    abstract::Anal fissure management has rapidly progressed in the last 15 years as our understanding of fissure pathophysiology has developed. All methods of treatment aim to reduce the anal sphincter spasm associated with chronic anal fissures. Surgical techniques have been used for over 100 years with success. Lateral internal ...

    journal_title:Techniques in coloproctology

    pub_type: 杂志文章,评审


    authors: Collins EE,Lund JN

    更新日期:2007-09-01 00:00:00

  • Outcomes of sacral neuromodulation for chronic pelvic pain: a Finnish national multicenter study.

    abstract:BACKGROUND:The aim of this study was to report the outcomes of sacral neuromodulation (SNM) in chronic pelvic pain (CPP) patients in the Finnish national cohort. METHODS:This was a register-based retrospective study, involving all the centers that provide SNM treatment in Finland. The data of all patients treated with...

    journal_title:Techniques in coloproctology

    pub_type: 杂志文章


    authors: Zegrea A,Kirss J,Pinta T,Rautio T,Varpe P,Kairaluoma M,Aho M,Böckelman C,Lavonius M

    更新日期:2020-03-01 00:00:00

  • Right sided colorectal cancer increases with age and screening should be tailored to reflect this: a national cancer database study.

    abstract:BACKGROUND:In the United States, colorectal cancer (CRC) screening and surveillance is recommended until age 75. However, rates of surgery for CRC are greatest in the elderly, questioning current guidelines. Tumor sidedness is an emerging prognostic marker that may help guide screening and treatment decisions, with spe...

    journal_title:Techniques in coloproctology

    pub_type: 杂志文章


    authors: Reif de Paula T,Simon HL,Profeta da Luz MM,Keller DS

    更新日期:2020-08-27 00:00:00

  • Beyond hematoxylin and eosin: the importance of immunohistochemical techniques for evaluating surgically resected constipated patients.

    abstract::Chronic constipation requiring surgical ablation for intractability is often a frustrating condition from the pathologist's point of view. In fact, limiting the histological examination to only hematoxylin-eosin staining usually yields only the information that there are no abnormalities. By employing some simple and ...

    journal_title:Techniques in coloproctology

    pub_type: 杂志文章,评审


    authors: Bassotti G,Villanacci V,Salerni B,Maurer CA,Cathomas G

    更新日期:2011-12-01 00:00:00

  • Sacrococcygeal dimensions and curvature are associated with resection quality in rectal cancer excision.

    abstract:BACKGROUND:Technical factors affect oncologic outcomes in rectal cancer surgery. The anatomy of the bony pelvis can affect technical aspects of surgery, but is seldom considered preoperatively. We performed a morphometric analysis of the bony pelvis in patients having rectal cancer resection to assess its effect on sur...

    journal_title:Techniques in coloproctology

    pub_type: 杂志文章


    authors: Simpson G,Marks T,Blacker S,Smith D,Walsh C

    更新日期:2020-10-01 00:00:00

  • Defunctioning ileostomy closure following low anterior resection by chemotherapy.

    abstract:AIM:The aim of this study is to review the time between formation and closure of loop ileostomies following total mesorectal excision in patients with rectal cancer. PATIENTS AND METHODS:A retrospective study of 170 patients who underwent low anterior resection for rectal cancer, between 1990 and 2009. Loop ileostomie...

    journal_title:Techniques in coloproctology

    pub_type: 杂志文章


    authors: Vrakas G,Pramateftakis MG,Kanellos D,Sapidis S,Hatzigianni P,Tsachalis T,Kanellos I,Lazaridis Ch

    更新日期:2010-11-01 00:00:00

  • Lymph road mapping obtained via blue sentinel node detection to avoid middle colic artery resection for highly selected colon cancer cases: proof of a concept?

    abstract:BACKGROUND:In theory, perioperative detection of lymph nodes with the injection of isosulfan blue dye should provide lymph road mapping (LRM) able to direct the resection. However, there is no supporting evidence for this theory in cases of colon cancer. We reanalysed all operative reports using the sentinel lymph node...

    journal_title:Techniques in coloproctology

    pub_type: 杂志文章


    authors: Lo Dico R,Lasser P,Goérè D,Malka D,Boige V,Pocard M

    更新日期:2010-09-01 00:00:00

  • Currently available and experimental dyes for intraoperative near-infrared fluorescence imaging of the ureters: a systematic review.

    abstract:BACKGROUND:Iatrogenic ureteral injury (IUI) following abdominal surgery has a relatively low incidence, but is associated with high risks of morbidity and mortality. Conventional assessment of IUI includes visual inspection and palpation. This is especially challenging during laparoscopic procedures and has translated ...

    journal_title:Techniques in coloproctology

    pub_type: 杂志文章


    authors: Slooter MD,Janssen A,Bemelman WA,Tanis PJ,Hompes R

    更新日期:2019-04-01 00:00:00

  • Metastasis to lymph nodes around the vascular tie worsens long-term oncological outcomes following complete mesocolic excision and conventional colectomy for right-sided colon cancer.

    abstract:BACKGROUND:Oncologic outcomes after complete mesocolic excision (CME) in colon cancer are under investigation. The aim of our study was to compare CME and conventional colectomy (CC) in terms of pathological and oncological outcomes for right colon cancer and to evaluate the impact of lymph node metastasis around the v...

    journal_title:Techniques in coloproctology

    pub_type: 杂志文章


    authors: Zenger S,Aytac E,Gurbuz B,Ozben V,Ozoran E,Baca B,Balik E,Hamzaoglu I,Karahasanoglu T,Bugra D

    更新日期:2021-01-05 00:00:00