Bowel preparation prior to reconstructive urologic surgery in pediatric myelomeningocele patients

Nicholas J. Farber, Rachel B. Davis, Gwen M. Grimsby, Brian Shinder, Glenn M. Cannon, Micah A. Jacobs, Michael C. Ost, Francis X. Schneck, Heidi A. Stephany, Patricio C. Gargollo, Moira E. Dwyer

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Introduction: Mechanical bowel preparation (MBP) has historically been the standard of care for patients undergoing reconstructive urologic surgery, including urinary diversion. To date, several studies have examined the role of mechanical bowel preparation in postoperative outcomes in pediatric patients undergoing augmentation cystoplasty. However, these patient populations have been heterogeneous in nature, with no studies dedicated to examining the role of MBP prior to reconstructive urologic surgery in pediatric patients with myelomenginoceles. Thus, our objective was to retrospectively assess perioperative measures and postoperative complications after reconstructive urologic surgery with or without mechanical bowel preparation in pediatric myelomeningocele patients. Materials and methods: From 2008 to 2013, 80 patients with myelomeningocele underwent reconstructive urologic surgery involving the use of bowel. Seventy patients underwent a preoperative MBP while 10 did not. Perioperative measures and postoperative complications for these two cohorts were assessed. Results: Eighty patients with myelomeningocele were identified; 70 patients underwent MBP while 10 patients did not. There were no statistically significant differences in demographics or operative time. There were no statistically significant differences in postoperative outcomes including time to first bowel movement and time to tolerating diet. There was also no significant difference in overall complication rate; patients with MBP had 31/70 (44%) complications while 2/10 (20%) of those without MBP had complications (p = 0.18). Conclusion: There was no significant difference in perioperative measures and postoperative complications for patients who did not receive a mechanical bowel preparation. Our findings indicate that it is safe and warranted to perform a prospective, randomized study to better characterize the risks and benefits of preoperative bowel preparation for patients with myelomeningocele.

Original languageEnglish (US)
Pages (from-to)9038-9042
Number of pages5
JournalCanadian Journal of Urology
Volume24
Issue number5
StatePublished - 2017

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Reconstructive Surgical Procedures
Meningomyelocele
Pediatrics
Urinary Diversion

Keywords

  • Bowel preparation
  • Myelomeningocele
  • Postoperative complications
  • Reconstructive urologic surgery

ASJC Scopus subject areas

  • Urology

Cite this

Farber, N. J., Davis, R. B., Grimsby, G. M., Shinder, B., Cannon, G. M., Jacobs, M. A., ... Dwyer, M. E. (2017). Bowel preparation prior to reconstructive urologic surgery in pediatric myelomeningocele patients. Canadian Journal of Urology, 24(5), 9038-9042.

Bowel preparation prior to reconstructive urologic surgery in pediatric myelomeningocele patients. / Farber, Nicholas J.; Davis, Rachel B.; Grimsby, Gwen M.; Shinder, Brian; Cannon, Glenn M.; Jacobs, Micah A.; Ost, Michael C.; Schneck, Francis X.; Stephany, Heidi A.; Gargollo, Patricio C.; Dwyer, Moira E.

In: Canadian Journal of Urology, Vol. 24, No. 5, 2017, p. 9038-9042.

Research output: Contribution to journalArticle

Farber, NJ, Davis, RB, Grimsby, GM, Shinder, B, Cannon, GM, Jacobs, MA, Ost, MC, Schneck, FX, Stephany, HA, Gargollo, PC & Dwyer, ME 2017, 'Bowel preparation prior to reconstructive urologic surgery in pediatric myelomeningocele patients', Canadian Journal of Urology, vol. 24, no. 5, pp. 9038-9042.
Farber, Nicholas J. ; Davis, Rachel B. ; Grimsby, Gwen M. ; Shinder, Brian ; Cannon, Glenn M. ; Jacobs, Micah A. ; Ost, Michael C. ; Schneck, Francis X. ; Stephany, Heidi A. ; Gargollo, Patricio C. ; Dwyer, Moira E. / Bowel preparation prior to reconstructive urologic surgery in pediatric myelomeningocele patients. In: Canadian Journal of Urology. 2017 ; Vol. 24, No. 5. pp. 9038-9042.
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abstract = "Introduction: Mechanical bowel preparation (MBP) has historically been the standard of care for patients undergoing reconstructive urologic surgery, including urinary diversion. To date, several studies have examined the role of mechanical bowel preparation in postoperative outcomes in pediatric patients undergoing augmentation cystoplasty. However, these patient populations have been heterogeneous in nature, with no studies dedicated to examining the role of MBP prior to reconstructive urologic surgery in pediatric patients with myelomenginoceles. Thus, our objective was to retrospectively assess perioperative measures and postoperative complications after reconstructive urologic surgery with or without mechanical bowel preparation in pediatric myelomeningocele patients. Materials and methods: From 2008 to 2013, 80 patients with myelomeningocele underwent reconstructive urologic surgery involving the use of bowel. Seventy patients underwent a preoperative MBP while 10 did not. Perioperative measures and postoperative complications for these two cohorts were assessed. Results: Eighty patients with myelomeningocele were identified; 70 patients underwent MBP while 10 patients did not. There were no statistically significant differences in demographics or operative time. There were no statistically significant differences in postoperative outcomes including time to first bowel movement and time to tolerating diet. There was also no significant difference in overall complication rate; patients with MBP had 31/70 (44{\%}) complications while 2/10 (20{\%}) of those without MBP had complications (p = 0.18). Conclusion: There was no significant difference in perioperative measures and postoperative complications for patients who did not receive a mechanical bowel preparation. Our findings indicate that it is safe and warranted to perform a prospective, randomized study to better characterize the risks and benefits of preoperative bowel preparation for patients with myelomeningocele.",
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AU - Davis, Rachel B.

AU - Grimsby, Gwen M.

AU - Shinder, Brian

AU - Cannon, Glenn M.

AU - Jacobs, Micah A.

AU - Ost, Michael C.

AU - Schneck, Francis X.

AU - Stephany, Heidi A.

AU - Gargollo, Patricio C.

AU - Dwyer, Moira E.

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N2 - Introduction: Mechanical bowel preparation (MBP) has historically been the standard of care for patients undergoing reconstructive urologic surgery, including urinary diversion. To date, several studies have examined the role of mechanical bowel preparation in postoperative outcomes in pediatric patients undergoing augmentation cystoplasty. However, these patient populations have been heterogeneous in nature, with no studies dedicated to examining the role of MBP prior to reconstructive urologic surgery in pediatric patients with myelomenginoceles. Thus, our objective was to retrospectively assess perioperative measures and postoperative complications after reconstructive urologic surgery with or without mechanical bowel preparation in pediatric myelomeningocele patients. Materials and methods: From 2008 to 2013, 80 patients with myelomeningocele underwent reconstructive urologic surgery involving the use of bowel. Seventy patients underwent a preoperative MBP while 10 did not. Perioperative measures and postoperative complications for these two cohorts were assessed. Results: Eighty patients with myelomeningocele were identified; 70 patients underwent MBP while 10 patients did not. There were no statistically significant differences in demographics or operative time. There were no statistically significant differences in postoperative outcomes including time to first bowel movement and time to tolerating diet. There was also no significant difference in overall complication rate; patients with MBP had 31/70 (44%) complications while 2/10 (20%) of those without MBP had complications (p = 0.18). Conclusion: There was no significant difference in perioperative measures and postoperative complications for patients who did not receive a mechanical bowel preparation. Our findings indicate that it is safe and warranted to perform a prospective, randomized study to better characterize the risks and benefits of preoperative bowel preparation for patients with myelomeningocele.

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