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Mechanical bowel preparation prior to gynaecological laparoscopy enables better operative field visualization, lower pneumoperitoneum pressure and Trendelenburg angle during the surgery: a perspective that may add to patient safety

dc.contributor.coauthorYassa, M.
dc.contributor.coauthorBakay, K.
dc.contributor.coauthorHatırnaz Ş.
dc.contributor.departmentKUH (Koç University Hospital)
dc.contributor.departmentSchool of Medicine
dc.contributor.kuauthorKalkan, Üzeyir
dc.contributor.schoolcollegeinstituteKUH (KOÇ UNIVERSITY HOSPITAL)
dc.contributor.schoolcollegeinstituteSCHOOL OF MEDICINE
dc.date.accessioned2024-11-09T12:42:29Z
dc.date.issued2021
dc.description.abstractBackground: to find the effects of mechanical bowel preparation (MBP) on operative field visualization, and to measure pneumoperitoneum pressure (PP) and Trendelenburg inclination angle (TIA) values. Methods: in this two-centred, randomised, single-blind and controlled study, 90 patients who underwent laparoscopic gynaecological surgery for benign conditions were included. After the exclusions, 44 patients received MBP with oral sodium phosphate enema (study group) and 42 did not receive bowel preparation or underwent diet restrictions (control group). An objective visual index, PP and TIA were measured in a stepwise design of assessments. Results: the Visual Index at first inspection right after establishing a 12 mmHg PP and a standard 30° TIA was found to be significantly in favour of the study group (p = 0.015). The lowest reached TIA in standard 12 mmHg PP following stepwise decrease was observed as 15.2° and 25° in the study and control groups, respectively (p < 0.001). The lowest reached PP was 8.9 mmHg and 11.9 mmHg in the study and control groups, respectively (p<0.001). Patients who received MBP reported significantly higher levels of negative discomfort measures (p <0.032), however 80% of those reported MBP as acceptable. Conclusion: significantly better operative field visualization, lower TIA and PP was achieved with MBP. MBP enabled a decrement of either 10° in TIA or 3 mmHg in PP with an adequate operative field to proceed safely for the benign gynaecological laparoscopic operations in exchange for acceptable discomfort for the patients.
dc.description.fulltextYES
dc.description.indexedbyWOS
dc.description.indexedbyScopus
dc.description.issue4
dc.description.openaccessYES
dc.description.publisherscopeInternational
dc.description.sponsoredbyTubitakEuN/A
dc.description.sponsorshipN/A
dc.description.versionPublisher version
dc.description.volume48
dc.identifier.doi10.31083/j.ceog4804134
dc.identifier.embargoNO
dc.identifier.filenameinventorynoIR03272
dc.identifier.issn0390-6663
dc.identifier.quartileQ4
dc.identifier.scopus2-s2.0-85113563276
dc.identifier.urihttps://doi.org/10.31083/j.ceog4804134
dc.identifier.wos700401100011
dc.keywordsLaparoscopy
dc.keywordsMechanical bowel preparation
dc.keywordsPneumoperitoneum pressure
dc.keywordsTrendelenburg angle
dc.language.isoeng
dc.publisherIMR Press
dc.relation.grantnoNA
dc.relation.ispartofClinical and Experimental Obstetrics and Gynecology
dc.relation.urihttp://cdm21054.contentdm.oclc.org/cdm/ref/collection/IR/id/10055
dc.subjectObstetrics
dc.subjectGynecology
dc.titleMechanical bowel preparation prior to gynaecological laparoscopy enables better operative field visualization, lower pneumoperitoneum pressure and Trendelenburg angle during the surgery: a perspective that may add to patient safety
dc.typeJournal Article
dspace.entity.typePublication
local.contributor.kuauthorKalkan, Üzeyir
local.publication.orgunit1SCHOOL OF MEDICINE
local.publication.orgunit1KUH (KOÇ UNIVERSITY HOSPITAL)
local.publication.orgunit2KUH (Koç University Hospital)
local.publication.orgunit2School of Medicine
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