Preoperative bowel preparation promotes intestinal functional recovery after esophagectomy
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Abstract:
Background: Patients are prone to intestinal dysfunction after esophagectomy. The value of preoperative bowel preparation before esophagectomy is controversial. There is a lack of evidence as to whether preoperative bowel preparation can help patients improve bowel function and shorten the recovery time of bowel function.
Objectives: The objectives of this study were to explore whether preoperative bowel preparation can promote the recovery of intestinal function after esophagectomy.
Methods: We analysed 139 patients who underwent elective radical esophagectomy in the Department of Thoracic Surgery at the Second Affiliated Hospital of Xi'an Jiaotong University from May 2016 to December 2018. The enrolled patients were divided into the study group (bowel preparation group) and the control group (no bowel preparation group) of 71 cases and 68 cases. Patients in the study group were given dissolved polyethylene glycol electrolyte powder and a cleansing enema the day before surgery. Patients in the control group were neither given polyethylene glycol electrolyte powder nor cleansing enemas before surgery. The postoperative recovery of the two groups were compared.
Results: Postoperative bed rest time, bowel function recovery time and the time of first flatus and defecation after surgery were significantly shorter in patients with bowel preparation than in those without bowel preparation, and the differences were statistically significant. (P=0.038, P﹤0.001, P﹤0.001, P﹤0.001; respectively).
Conclusions: Preoperative bowel preparation can promote the recovery of patients with esophageal cancer, especially the recovery of bowel function, which can reduce the pain caused by abdominal distension and improve the quality of life of patients.
Keywords: Intestinal dysfunction; esophagectomy; retrospective cohort study.Keywords:
Esophagectomy
Bowel preparation
Enema
Abdominal distension
Bowel function
Objective To investigate the effect of using OB built-in tampon for elderly patients with anal sphincter relaxation.Methods Total 60 elderly patients with anal sphincter relaxation were randomly divided into two groups,30 cases in each group: the OB built-in tampon group and the control group.We compared the time between the first defecation and enema,times of defecation in the first day after enema,peri-anal skin integrity and the prognosis of patients between the two groups.Results First defecation time was (5.90 ± 1.96) h,times of defecation per day was ( 3.27 ± 1.05 ),those in control group were ( 3.40 ± 1.37 ) h,( 4.57 ± 0.86 ),respectively,and the difference was significant (t =-7.633,5.255;P ＜0.01 ).Using the OB built-in tampon prolonged the time between the first defecation and enema,decreased the times of defecation in the first day after enema,the effective rate was 96.7％ OB built-in tampon,and 76.7％ in control group,and the difference was statistically significantly ( x2 =5.192,P =0.023 ).Peri-anal skin integrity has improved than control group ( P ＜0.05).Conclusions OB built-in tampon is a reasonable and effective measurement for elderly patients with anal sphincter relaxation.
Key words:
Elderly; OB built-in tampon; Retention enema; Anal sphincter relaxation
Enema
Anal sphincter
Internal anal sphincter
Obstructed defecation
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Background: Lower gastrointestinal endoscopy requires adequate bowel preparation. However there is no unanimous recommendation on choice of agent of bowel preparation for the purpose of screening flexible sigmoidoscopy.Objective: To compare the quality of bowel preparation and patient’s tolerance between Enema (Solution of Glycerin 15% w/v and Sodium Chloride 15% w/v)and Polyethylene glycol for screening flexible sigmoidoscopy.Methodology: All consecutive patients undergoing screening flexible sigmoidoscopy were included in the study. We prospectively divided the patients into two groups. Group A received per rectal enema and group B received oral bowel preparation with polyethylene glycol. Adequacy of bowel preparation and patient’s tolerance between two groups was graded. Data were analysed using Microsoft Excel 2010.Results: Results were comparable regarding quality of bowel preparation between two groups (A and B), excellent in 20% and 33.33% and good in 60% and 50% respectively. Almost all patients could tolerate the preparation agent in Group A (n=28). In-group B, eight patients (26.66%) considered the oral preparation agent difficult to tolerate and two patients (6%) were unable to complete the preparation.Conclusion: Enema (Solution of Glycerin 15% w/v and Sodium Chloride 15% w/v) and Polyethylene glycol have similar quality of bowel preparation and for screening sigmoidos copy. Enema is adequate and much easily tolerable compared to polyethylene glycol. Journal of Kathmandu Medical College,Vol. 7, No. 2, Issue 24, Apr.-Jun., 2018, page: 50-54
Sigmoidoscopy
Enema
Bowel preparation
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Objective To discuss the effect of glycerol enema, glycerine enema on systolic pressure (SP) of soapsuds enema patients with hypertensive intracerebral hemorrhage (ICH).Methods Hypertensive ICH patients with constipation were divided into three groups at random, who used three different purgatives.Systolic pressure and defecation were observed.Results Different purgatives has different effects on SP change and defecation.Soapsuds enema had the most favorable effect on SP change and the rate was the fastest,but increased the frequency of defecation. Glycerine enema had the smallest effect on SP but the purgative effect was the poorest. Glycerol enema had the smallest effect on SP and the best purgative effect.Conclusion Appropriate purgatives should be selected according to actual conditions of individual patients in nursing practice.
Enema
Cathartic
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Objective To compare the clearing effect between the combination use of glycerine enema plus polyethylene glycol( PEG) and the use of PEG only for the colonoscopy preparation of patients with constipation. Method Patients with the number of 120 who would have colonoscopy were randomly divided into experimental group and control group,and each group included 60 patients. PEG of 2 L was given in control group. Whereas in the experimental group,glycerine enema of 60 ml was used when patients took half the amount of PEG,and 2 tablets of phenolphthalein were also given to patients before sleep the day before colonoscopy. To compare the time of the first defecation,the time of completion of bowel cleaning,the frequency of defecation and the cleaning quality of the bowel. Result The time of the first defecation and the time of the completion of bowel cleaning of the experimental group were shorter( P 0. 01). The frequency of defecation of the experimental group was higher( P 0. 01). The cleaning quality of the bowel in the experimental group was also higher( P 0. 05). Conclusion the combination use of glycerine enema plus polyethylene glycol( PEG) for colonoscopy preparation of patients with constipation tends to shorten the time of completion of bowel cleaning and improve the cleaning quality of the bowel.
Enema
Bisacodyl
Cathartic
Bowel preparation
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In patients often require repeated colonoscopy as a result of poor colonic preparation. A study of 101 inpatients was conducted to determine the most effective bowel preparation strategies. Results suggest patients on certain medications and with certain medical histories react differently to bowel preparation. Patients with diabetes, renal disease, chronic obstructive pulmonary disease, or chronic constipation should receive a more aggressive preparation to obtain optimal results. Likewise, patients who are taking narcotics and laxatives need to be identified and can be expected to require additional preparation to be properly cleansed. Clear liquid diet prior to the administration of the bowel preparation was the only diet modification that affected quality of preparation. The optimal bowel preparation was a 6-liter Golytely® preparation along with a secondary preparation (e.g., tap water enema, Fleets enema, Dulcolax tablets). Results showed a 50% satisfactory rating of bowel preparation was achieved in patients who took 3/4 to all of their preparation. The best results were obtained when the colonoscopy procedure was conducted within 6–11 hours of bowel preparation completion.
Bowel preparation
Enema
Cathartic
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To investigate the effect of retention-enema of Bowels-Unblocking and Heat-Purging Mixture (BHM) combined with electro-acupuncture (EA) for peritonitis after operative.In admission order, 32 cases of acute diffuse peritonitis were allocated to group A and were treated with retention-enema of BHM and EA based on routine western medicine 6 hours after operation.Other 28 cases in group B were treated with routine western medicine only. Recovery time of bowel sound,passing flatus and defecation was observed after operation as well as post-operative complications, multiple organs dysfunction syndrome (MODS) and multiple organ failure (MOF).After operation, recovery time of bowel sounding,passing flatus and defecation was 20.32±4.34, 29.43±9.66 and 40.69±13.69 hours in group A respectively, which differed from 30.66±6.06, 40.66±17.33 and 66.48±17.58 hours in group B (P0.05). Post-operative pulmonary infection, symptomatic intestinal adhension (SIA), MODS, MOF and death rate were reduced in group A as compared with group B.[Conclusion]Retention-enema of BHM combined with EA exerts a good effect in treating acute diffuse peritonitis.
Enema
Group B
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Objective To design and apply a kind of controllable enema input apparatus in patients with spinal cord injury(SCI). Methods 20 SCI patients with chronic constipation were included. Their defecation time, nature of defecation and usage of enema of 5 times of defecation were recorded before and after using the new apparatus. Results There were significant differences in the defecation time, nature of defecation and usage of enema before and after using the new apparatus(P0.05). Conclusion The application of the new controllable enema input apparatus may shorten the defecation time, improve the nature of defecation, and reduce the usage of enema in SCI patients with chronic constipation.
Enema
Obstructed defecation
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Objective To explore the applied effect of XQTBT paste on early recovery of gastrointestinal function of patients after abdominal operation. Method 150 patients after abdominal operation in general surgery of my hospital were divided into two groups the observation group(75 patients)and the control group(75 patients). The control group was gived to some nursing care ,for example, fasting,fluid replacement,gastrointestinal decompression, moving extremities,turning the body over and getting out of bed by our assistance. Nevertheless,XQTBT was applied to the observation group besides routine nursing care of the control group .The convalescent time of bowel sound and the first time of flatus and defecation of the patients in each group were recorded and compared in order to study the difference of their gastrointestinal functional recovery. Results The convalescent time of bowel sound and the first time of flatus and defecation in the observation group was obviously earlier than that of the control group. there were significantly differences between the two groups(P＜0.05). Conclu1sion The therapeutic effect which XQTBTdeals with abdominal distension after operatiom and enhances the recovery of gastrointestinal function is overt, and it is safe, comfortable and can be easily attended without any trauma. It benefits the early recovery of gastrointestinal function after abdominal operation.
Key words:
Abdominal operation; Gastrointestinal function; XQTBT; Nursing
Gastrointestinal function
Abdominal distension
Bowel function
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Objective To evaluate the influence of Sizi powder hot-cover packet applied in abdomen acupoint on the recovery of gastrointestinal function of patients after lumbar operation.Methods 100 patients after lumbar operation were randomly divided into control group(n=50) and experiment group(n=50).Patients in control group received routine care(fasting,prostration,monitoring of vital signs,psychological nursing,etc.),while patients in experiment group received both routine nursing and the application of Sizi powder hot-cover packet.Abdominal distension,bowel sounds,exhaust and defecation in two groups were observed.Results The differences of abdominal distension,bowel sounds,exhaust and defecation of patients in two groups indicated statistic significance(P0.01).Conclusion The external application of Sizi powder hot-cover packet can alleviate patients' pain after lumbar spine surgery,shorten time to flatus defecation,reduce abdominal distension,and promote the recovery of gastrointestinal function.
Abdominal distension
Gastrointestinal function
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Objective To observe and evaluate the effects of Bacillus coagulans tablets in preventing post-cesarean gastrointestinal dysfunction.Methods 60 pregnant women were randomly divided into two groups: prevention group(n=30) and control group(n=30).In prevention group,Bacillus coagulans tablets were administered at dose of 2.1 g for the first time,then 1.05 g per time and three times a day.The symptoms including constipation,abdominal discomfort,abdominal distension,abdominal pain and inappetence,etc.after cesarean section were observed.Results The time of first defecation of prevention group was much shorter than that of control group.The frequency of defecation in prevention group were significantly higher,and the incidences of abdominal discomfort,abdominal distension,and exertion in defecation were significantly less than control group(P0.05).Conclusion This study suggests a beneficial effect of Bacillus coagulans tablets in preventing post-cesarean gastrointestinal dysfunction.
Bacillus coagulans
Abdominal distension
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