Controversies in preoperative bowel preparation in gynecologic and gynecologic oncology surgery: a review of the literature.
Arch Gynecol Obstet
; 302(5): 1049-1061, 2020 11.
Article
em En
| MEDLINE
| ID: mdl-32740871
ABSTRACT
PURPOSE:
The purpose of this review is to assess the impact of mechanical and oral antibiotics bowel preparation on surgical performance and to investigate their role before gynecologic surgical procedures regarding the infection rates. We also aim to study the updated evidence regarding the use of these different types of bowel preparation, as well as the current preoperative practice applied.METHODS:
An extensive search of the literature was conducted with Medline/PubMed, and the Cochrane Library Database of Systematic Reviews being used for our primary search.RESULTS:
To date, due to the conflicting guidelines by the scientific societies, surgeons do not use a specific pattern of bowel preparation regimen. There are no strong evidence supporting mechanical bowel preparation, but instead, in many cases, patients' adverse effects, both physiological and psychological have been noted. On the other hand, the combined use of oral antibiotic and mechanical bowel preparation has been proven beneficial in colorectal surgery in reducing postoperative morbidities.CONCLUSION:
Based on current literature, in gynecologic surgeries with minimal probability of intraluminal entry, a regimen without any bowel preparation should be applied. The combined administration of both mechanical and oral antibiotic bowel preparation, or even the use of the oral antibiotics alone, should be preserved for cases of increased complexity, where bowel involvement is highly anticipated, such as in gynecologic oncology, as stated in the ERAS protocols. Nonetheless, further research specific to gynecologic surgery is required.Palavras-chave
Texto completo:
1
Bases de dados:
MEDLINE
Assunto principal:
Procedimentos Cirúrgicos em Ginecologia
/
Infecção da Ferida Cirúrgica
/
Cuidados Pré-Operatórios
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Antibioticoprofilaxia
/
Neoplasias dos Genitais Femininos
/
Antibacterianos
Tipo de estudo:
Etiology_studies
/
Guideline
Limite:
Female
/
Humans
Idioma:
En
Revista:
Arch Gynecol Obstet
Assunto da revista:
GINECOLOGIA
/
OBSTETRICIA
Ano de publicação:
2020
Tipo de documento:
Article
País de afiliação:
Grécia