QS106 - Comparison of Surgical Site Infection by Low vs Large Volume Bowel Preparation in Colorectal Cancer Surgery: Multicenter Randomized Controlled Trial

Sunday, June 2, 2024

8:36 AM – 8:39 AM ET, USA

Location: Room 327

Quick Shot Presenter(s)

SUNG MIN LEE, MD

Clinical professor
Kyungpook National University Chilgok Hospital
Kyungpook National University
Daegu, Taegu-jikhalsi, Republic of Korea

All relevant financial disclosures have been managed and will be listed below.
This individual has no financial relationships with ineligible companies.

Author(s)

JA

Johanna M. An, B.A., MD Candidate

Medical Student
Medical College of Wisconsin
Milwaukee, Wisconsin, United States

Disclosure information not submitted.
HK

Hye Jin Kim, n/a

Professor
Kyungpook National University Hospital
Daegu, Taegu-jikhalsi, Republic of Korea

Disclosure information not submitted.
SP

Su Yeon Park, n/a

Professor
Kyungpook National University Hospital
Daegu, Taegu-jikhalsi, Republic of Korea

Disclosure information not submitted.
SS

SEUNG HO SONG, n/a

Professor
Kyungpook National University Chilgok Hospital
Daegu, Taegu-jikhalsi, Republic of Korea

Disclosure information not submitted.
SK

Su Jin Kang, n/a

Clinical fellow
Kyungpook National University Hospital
Daegu, Taegu-jikhalsi, Republic of Korea

Disclosure information not submitted.
Mj

Min Hye jung, n/a

Clinical fellow
Kyungpook National University Hospital
Daegu, Taegu-jikhalsi, Republic of Korea

Disclosure information not submitted.

Senior Author(s)

JP

JUN SEOK PARK, n/a

Professor
Kyungpook National University Chilgok Hospital
Daegu, Taegu-jikhalsi, Republic of Korea

Disclosure information not submitted.

Purpose/Background: Polyethylene glycol (PEG) was known to be effective for reducing surgical site infection (SSI) in colorectal surgery. However, patients suffered from large volume (up to 4L) of dosage and unpleasant abdominal symptoms caused by the agent. We tried to identify clinical efficacy and patient’s satisfaction of low volume bowel preparation, Sodium picosulfate and magnesium sulfate (PICO) to large volume bowel preparation, PEG in the setting of randomized trial.

Methods/Interventions: From July 2019, patient who were diagnosed as colorectal adenocarcinoma enrolled from 4 tertiary university hospital. Patients who showed obstructive symptom and needed preoperative colonoscopy were excluded from study. Primary outcome was surgical site infection (SSI) which is defined by U.S. Centers for Disease Control and Prevention in 1999. Sample size were calculated as total 298 patients assuming non-inferiority margin of PICO as 10%. Completeness of bowel preparation was measured by surgeons at the operation theatre using scoring from 0 to 10. Patient’s tolerance of 2 bowel preparation agents was measured by self-administered questionnaire, which consisted of 6 questions; abdominal distension, pain, nausea, vomiting, discomfort, willingness to use same agent again.

Results/Outcomes: Until Dec 2022, 203 patients (103 in PICO group, 100 in PEG group) were included in this analysis. The rate of SSI was not different between 2 groups (7.9% in PICO, 8.0% in PEG , P=0,627). Organ space SSI was 3 in PICO group and 5 in PEG group, among them 5 patient were related with anastomosis leakage. Surgeon’s satisfaction of bowel preparation was 8 (interquartile range: 8-9) in PICO group and 8 (interquartile range : 7-9) in PEG group (P=0.246). PICO groups showed better tolerance than PEG group in the questionnaire of nausea (10% vs 27%; P=0.004), vomiting (2% vs 10%; p=0.033), abdominal discomfort (15% vs 30%; p=0.048), and willingness to use again (82% vs 48%; P=0.001). The items of distension (19% in PICO vs 22.0% in PEG; P=0.631) and pain (3% in PICO vs 12% in PEG; P=0.065) were not different between groups.

Conclusion/Discussion: According to the present study , low volume bowel preparation was not inferior to large volume bowel preparation in terms of SSI rates. According to the present study. And surgeon’s satisfaction in the operation room was almost same. Furthermore, Patient’s tolerance was superior in low volume bowel preparation. In conclusion, Low volume bowel preparation might be satisfactory alternative to widely used large volume preparation in colorectal cancer surgery.