Review Article

Preoperative Bowel Preparation in Minimally Invasive and Vaginal Gynecologic Surgery

Table 1

Studies assessing the use of bowel preparation in minimally invasive gynecologic surgery.

Study (reference)Regimen of BP compared (group size/no. of patients)Outcomes of interest and results

Muzii et al. [18]MBP-oral NaP (81)No MBP (81)Greater patients’ discomfort in the MBP group
No difference in surgeons’ evaluation of the surgical field, operative difficulty, operative time, and postoperative complications

Lijoi et al. [19]MBP-oral granular powder dissolved in 1000 mL (41)1-week low fiber diet <10 g (42)No difference in evaluation of surgical field and operative time
Abdominal distension and overall discomfort were more frequent in MBP group
No difference in postoperative pain, nausea, abdominal swelling, ileus rate, and LOS

Yang et al. [11]MBP-oral NaP (72)MBP-NaP enema (73)No difference in evaluation of the surgical field, bowel handling, degree of bowel preparation, or surgical difficulty
Abdominal bloating and swelling, weakness, thirst, dizziness, nausea, fecal incontinence, and overall discomfort were greater in the oral solution group

Won et al. [17]Minimal residue diet + MPB-oral Na picosulphate (87)Minimal residue diet (84)Fasting only (86)Better surgical view with minimal residue diet + MBP
No difference in complications
Greater patients’ symptoms in MBP group (headache, thirst, weakness, tiredness, and overall discomfort) by VAS

Siedhoff et al. [8]MBP-single NaP enema (73)No MBP (73)No difference in anxiety by VAS
No difference in evaluation of surgical field
Same operative time and blood loss
No difference in postoperative constipation or patients’ rating of symptoms (cramps, hunger, bloating, embarrassment, weakness, dizziness, thirst, nausea, incontinence, and constipation)
Increased insomnia in no MBP group

Ryan et al. [20]MBP-oral magnesium citrate (39)No MBP (39)No difference in intraoperative visualization, bowel handling, or overall ease of the operation
Same compliance, preoperative and postoperative patients’ discomfort

Bakay and Aytekin [21]MBP-oral NaP (NR)No MBP (NR)No difference in operative time

Mulayim and Karadag [12]MBP-oral NaP (96)MBP-enema NaP (92)Fasting only (90)No difference in visualization of the surgical field, ease of bowel handling, and overall ease of surgery based on VAS score
No benefit of MBP when removing large uteri or when operating on patients with a high BMI
Preoperative overall discomfort score was better in the fasting-only group

MBP = mechanical bowel preparation; NaP = sodium phosphate; NR = not reported; LOS = length of hospital stay; VAS = visual analog scale; BMI = body mass index.