ROLE OF MECHANICAL BOWEL PREPARATION BEFORE COLOSTOMY REVERSAL; A RANDOMIZED CONTROL TRIAL.
Objectives: To see the outcome of colostomy reversal with and without mechanical bowel preparation. The purpose of the study is to determine whether the mechanical preparation before the elective colorectal surgery is more beneficial for the patients. Study Design: Randomized controlled trial. Settings: Department of General Surgery, Nishtar Medical University/Hospital, Multan. Period: 1st July 2016 to 31st December 2017. Materials & Methods: A total of 302 patients with sigmoid colostomy of more than 1 month duration and undergoing colostomy closure, patients above 12 years of age of both genders were included. Patients with h/o pelvic irradiation, peritonitis, CRF and CLD were excluded. Selected patients were placed randomly into two groups. Group A included cases in which mechanical bowel preparation was done 6 hours prior to operation while group B included patients in which no mechanical bowel preparation was done. Mean Hospital stay was noted in every patient of both groups from day of operation to day of discharge. Wound infection was noted on seventh post-operative day. Results: Mean age was 36.62 ± 7.23 years. Mean duration of disease was 3.05 ± 1.04 months. Mean hospital stay in group A (mechanical bowel preparation) was 5.29 ± 1.05 days and in group B (without mechanical bowel preparation) was 3.87 ± 1.17 days with p-value of 0.0001. Wound infection in group A (mechanical bowel preparation) was found in 19 (12.58%) and in group B (without mechanical bowel preparation) was found in 08 (5.30%) patients with p-value of 0.027. Conclusion: There were no significant effect of mechanical bowel preparation before colorectal surgery and no more benefit and it should be reserved for selective cases only.