Does a Preoperative Bowel Preparation Reduce Bowel Morbidity and Length of Stay After Scoliosis Surgery? A Randomized Prospective Study

作者：Smith John T^*; Smith Melissa S

来源：Journal of Pediatric Orthopaedics, 2013, 33(8): E69-E71.

DOI：10.1097/bpo.0b013e318296e032

• adolescent idiopathic scoliosis
• bowel morbidity
• preoperative bowel preparation

Background: Constipation is a common problem after surgery for adolescent idiopathic scoliosis (AIS), with bowel morbidity being reported as high as 78%. The purpose of this study was to determine if a preoperative bowel preparation reduces the incidence of bowel morbidity after surgery for AIS.
Methods: This is an IRB-approved randomized, prospective study of 60 consecutive patients who underwent surgery for AIS. After consent to participate was signed by the patients' family, patients were randomized to either a preoperative bowel preparation (group A) or no bowel preparation (group B). Bowel morbidity data were then collected and compared postoperatively.
Results: Complete data were available for 27 patients in group A and 28 in group B. Postoperatively, we found that group A had less weight gain (P < 0.09), fewer postoperative bowel medications (P < 0.023), and a shorter time to first bowel movement (P < 0.03) when compared with group B. Two patients in group B had persistent constipation after discharge, one requiring readmission to the hospital. One patient in group B developed a postoperative wound infection. There were no adverse events in group A postoperatively.
Conclusions: This study did show a modest reduction in some aspects of bowel morbidity when patients had a preoperative bowel preparation before scoliosis surgery. However, these differences did not reach statistical significance. Therefore, we do not recommend routine preoperative bowel preparations for AIS patients.

• 出版日期2013-12