Inpatient vs. outpatient bowel preparation for elective colorectal surgery. Editorial. Authors'replies.
Recent pressures to decrease the cost of medical care have mandated preoperative outpatient bowel preparation (OBP) for elective colorectal surgery without any data documenting equivalent quality of care.
This study examined the safety and efficacy of OBP compared with inpatient bowel preparation (IBP).
Records of all patients who underwent OBP for elective colorectal resection since the inception of the OBP program from July 1993 to June 1994 were compared with records of all patients who received IBP for elective procedures from January to June 1993.
The two groups, 90 patients who underwent OBP and 98 patient who had IBP, were well matched for age, sex, diagnosis, and operations performed.
The OBP group had a shorter length of hospital stay (median, 7 vs. 9 days ; P<0.0001 ; chi-squared analysis), whereas the complication rate was similar (19 percent in the OBP group vs. 18 percent in the IBP group), including infectious complications (10 percent in the OBP group vs. 7 percent in the IBP group).
Although operating time was similar (mean, 199 vs. 213 minutes) and estimated blood loss (mean, 528 vs. 536 ml), the OBP group had significantly higher perioperative fluid requirements : intraoperative fluids (median, 4300 vs. 3700 ml ; P<0.05 ; Student's t-test), intraoperative colloid administration (48 vs. 29 percent ; P<0.0002 ; chi-squared), 24-hour postoperative fluids (3224 vs. 2700 ml ; P<0.0001 ; Student's t-test), and p...
Mots-clés Pascal : Chirurgie, Côlon, Rectum, Préparation anatomique, Nettoyage, Hospitalisation, Ambulatoire, Résultat, Analyse coût, Etude comparative, Homme, Côlon pathologie, Rectum pathologie, Appareil digestif pathologie
Mots-clés Pascal anglais : Surgery, Colon, Rectum, Anatomical preparation, Cleaning, Hospitalization, Ambulatory, Result, Cost analysis, Comparative study, Human, Colonic disease, Rectal disease, Digestive diseases
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Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 96-0229958
Code Inist : 002B30A04D. Création : 199608.